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. 1996 Apr 30;93(9):3972–3977. doi: 10.1073/pnas.93.9.3972

Human immunodeficiency virus type 1 infection despite prior immunization with a recombinant envelope vaccine regimen.

M J McElrath 1, L Corey 1, P D Greenberg 1, T J Matthews 1, D C Montefiori 1, L Rowen 1, L Hood 1, J I Mullins 1
PMCID: PMC39470  PMID: 8633000

Abstract

With efforts underway to develop a preventive human immunodeficiency virus type 1 (HIV-1) vaccine, it remains unclear which immune responses are sufficient to protect against infection and whether prior HIV-1 immunity can alter the subsequent course of HIV-1 infection. We investigated these issues in the context of a volunteer who received six HIV-1LAI envelope immunizations and 10 weeks thereafter acquired HIV-1 infection through a high-risk sexual exposure. In contrast to nonvaccinated acutely infected individuals, anamnestic HIV-1-specific B- and T-cell responses appeared within 3 weeks in this individual, and neutralizing antibody preceded CD8+ cytotoxic responses. Despite an asymptomatic course and an initial low level of detectable infectious virus, a progressive CD4+ cell decline and dysfunction occurred within 2 years. Although vaccination elicited immunity to HIV-1 envelope, which was recalled upon HIV-1 exposure, it was insufficient to prevent infection and subsequent immunodeficiency.

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