Antibody Response to Diphtheria, Tetanus, and Poliomyelitis Vaccines in Relation to the Number of CD4+ T Lymphocytes in Adults Infected with Human Immunodeficiency Virus

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Abstract
A prospective study of antibody production by adults infected with human immunodeficiency virus (HIV) after vaccination with T lymphocyte-dependent diphtheria toxoid, tetanus toxoid, and inactivated trivalent poliovirus vaccine was conducted. Individuals were divided into three groups according to CD4+ T-lymphocyte count: group 1 had a count of ⩽100 × 106/L; group 2, 101–300 × 106/L; and group 3, >300 × 106/L. After vaccination, 61%, 70%, and 73% of the individuals in groups 1, 2, and 3, respectively, developed protective titers of antibody to diphtheria toxin; the mean postvaccination antibody titer of HIV-infected individuals was significantly lower than that of healthy controls not infected with HIV. Furthermore, the mean titers of antibodies to tetanus toxin and poliovirus were significantly lower in HIV-infected individuals with CD4+ lymphocyte counts of 6/L than in controls. Of the HIV-infected vaccinees, 83%–100% were protected against tetanus and 78%–100% against polio. We conclude that HIV-infected individuals with CD4+ lymphocyte counts of 6/L have an impaired (secondary) antibody response after receipt of T lymphocyte-dependent vaccines.

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