AIDSWEEKLY Plus, 16 September 1996
Daniel J. DeNoon, Senior Editor

Recipients of the Virogenetics canarypox HIV vaccine had no detectable HIV-specific IgA antibodies in mucosal secretions or saliva.

"The low HIV specific antibody levels detected in mucosal secretions from vaccinees suggests that local immunizations might be worth testing to stimulate a local immune response.," said Laurent Finkielsztein of Cochin Hospital, Paris, France.

Finkielsztein spoke during a presentation to the XI International Conference on AIDS, held July 7-12, 1996, in Vancouver, British Columbia, Canada.

Recognizing the increasing importance ascribed to mucosal immunity against HIV, Finkielsztein and colleagues set out to standardize methods for the evaluation of antibody responses in parotid saliva and cervico-vaginal secretions.

They enrolled 17 women with HIV infection and a mean CD4(+) T-cell count of 536 cells/(micro)L and 19 HIV healthy seronegative women.

"Our results show that in HIV-1 infected volunteers there is an important interpatient variability," Finkielsztein said. "IgG subtype is predominant over IgA subtype in cervico- vaginal secretions, and no local production is detected."

There was a strong correlation between titers of serum and mucosal antibodies.

Finkielsztein suggested that these data provide compelling evidence that most of the HIV specific IgG and IgA in mucosal fluids transude from the serum.

Vaccination with the canarypox vaccine elicited detectable anti-gp120 IgG in the cervico-vaginal secretions of about 60 percent of subjects. Only 10 percent of the subjects had detectable anti-gp120 antibody in their saliva, although anti- p24 IgG was widely detected.

But no HIV specific IgA antibodies could be found in mucosal secretions or saliva.

These findings led Finkielsztein to recommend that clinical trials investigate the ability of mucosally administered vaccination to elicit local IgG and IgA responses.

"Mucosal immunization is certainly going to be important," said session co-chair Ken Rosenthal of McMaster University, Hamilton, Ontario, Canada. "If one immunizes systemically it's very difficult to see good mucosal immune responses, so we certainly have a lot of challenges before us."

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