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VACUNAS

VACUNAS. FELIPE GARCÍA HOSPITAL CLINIC. BARCELONA RESUMEN 19TH CROI. VACUNAS Preventivas Terapéuticas e inmunoterapia Vacunas comerciales. VACUNAS Preventivas Terapéuticas e inmunoterapia Vacunas comerciales. RV144. RV144. RV144. RV144.

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VACUNAS

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  1. VACUNAS FELIPE GARCÍA HOSPITAL CLINIC. BARCELONA RESUMEN 19TH CROI

  2. VACUNAS • Preventivas • Terapéuticas e inmunoterapia • Vacunas comerciales

  3. VACUNAS • Preventivas • Terapéuticas e inmunoterapia • Vacunas comerciales

  4. RV144

  5. RV144

  6. RV144

  7. RV144

  8. UTILIZACION DE QUIMIOCINAS EN VACUNAS: MODELOS ANIMALES REALMENTE NO EVITA LA INFECCION EN MODELOS ANIMALES, SIMPLEMENTE AUMENTA EL NUMERO DE EXPOSICIONES PARA INFECTARSE DEPENDIENDO DEL TIPO DE QUIMIOCINAS PUEDEN ENFOCAR LA RESPUESTA INMUITARIA A MUCOSAS

  9. VACUNAS • Preventivas • Terapéuticas e inmunoterapia • Vacunas comerciales

  10. Significant Decrease of Viral Load (VL) with a Therapeutic Dendritic Cell (DC)- Based Vaccine in Patients with Chronic HIV-1 Infection (CHI) receiving Antiretroviral Therapy: A Phase I/II Blinded Randomized Placebo-Controlled Study Felipe García*1, Nuria Climent1, Cristina Gil1, Agathe León1, Brigitte Autran2, Jeff Lifson3, Bonaventura Clotet4, Josep M Gatell1, Montserrat Plana1, Teresa Gallart1 for DCV2/MANON07-ORVACS study group. Clinical trial.gov NCT00402142 1Hospital Clinic-IDIBAPS, HIVACAT, University of Barcelona. Barcelona.Spain  2INSERM UMR-S 945 - Université Paris VI Pierre et Marie Curie. Hôpital Pitié-Salpêtrière, Paris, France  3 AIDS and Cancer Virus Program, SAIC-Frederick, Inc., NCI-Frederick, Frederick, MD 21702, USA. 4 Hospital Germans Trias i Pujol, IRSICAIXA-HIVACAT, Badalona, Spain.

  11. CLINICAL TRIAL DESIGN ARM II CONTROL GROUP (N=12) Doses of NON- pulsed MD-DC cART Stop cART STOP 1 Virus culture Doses of pulsed MD-DC ARM I VACCINE (N=24) -144 -51 -48 -4 -2 0 2 4 48 WEEK Inclusion criteria 1. <20 copies/ml 2. Nadir >350 C CD4+ T c/mm3

  12. VIRAL LOAD RESPONSES VL SET-POINT IN DC-HIV: -1 log w12 and maintained > 0.5 log 1 year VL SET-POINT IN DC-placebo: < 0.5 log in all time points IT WAS OBSERVED A SIGNIFICANT DECREASE OF VL IN VACCINATED PATIENTS

  13. RESULTS cART initiation during study period* DC-PLACEBO 5/11: w16, w24, w36, w36: drop CD4 w36: consent withdrawal DC-HIV-1 7/24 w4: consent withdrawal w8, w12, w12, w36, w36: drop CD4 w36: drop platelets *cART was mandatory if CD4 T cell count drop below 300 cells/mm3

  14. CD4+ T CELL COUNT CHANGES CD4 T CELL COUNT DROP TO BASELINE LEVEL AFTER cART INTERRUPTION WITHOUT DIFFERENCE BETWEEN ARMS

  15. IL7: MEJORIA DE RESPUESTA INMUNITARIA IL7: MEJORIA DE CD4 TOTALES Y MEMORIA EN GALT Y CD4 Y CD8 EN SANGRE

  16. VACUNAS • Preventivas • Terapéuticas e inmunoterapia • Vacunas comerciales

  17. ZOSTER ALTA DOSIS DE GRIPE

  18. CONCLUSIONES • VACUNAS • Preventivas: • Anticuerpos es el “santo grial” • Parece que RV144 Ac frente a las asas V1-V2 podrían ser las responsables de la eficacia • Terapéuticas • A pesar de una mejora sustancial en la eficacia virológica las vacunas basadas en CD no han conseguido la curación funcional en ningún paciente

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