Immunity in the Presence of Chronic or Repeated Infection.

Abstract

Viral ImmunologyVol. 36, No. 5 EditorialFree AccessImmunity in the Presence of Chronic or Repeated InfectionRodney S. RussellRodney S. RussellAddress correspondence to: Dr. Rodney S. Russell, BioMedical Sciences, Memorial University of Newfoundland, 300 Prince Philip Dr., St. John's, Newfoundland and Labrador A1C 5S7, Canada E-mail Address: rodney.russell@med.mun.caBioMedical Sciences, Memorial University of Newfoundland, St. John's, Canada.Search for more papers by this authorPublished Online:14 Jun 2023https://doi.org/10.1089/vim.2023.0073.editorialAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail In this issue, we have a balanced mix of immune analysis in the context of chronic viral infections, including chronic hepatitis B virus (HBV), Epstein–Barr virus (EBV), and human immunodeficiency virus (HIV), as well as three studies related to coronavirus disease 2019 (COVID-19) vaccination and immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). EBV has received much attention recently due to a newly confirmed association between EBV and multiple sclerosis. Yanqing Yao et al. review the immune response to EBV infection and mechanisms employed by this virus to evade the immune system.In a study by Chun-Yan Yao et al., the expression of CD32, a member of the FcγR family, was analyzed on CD4+ and CD8+ T cells in the context of HBV infection to determine whether CD32 levels on T cells could have clinical utility in the assessment of liver injury. The authors found that in HBV-infected individuals, there was a significant positive correlation between CD4+ T, CD8+ T CD32 mean fluorescence intensity (MFI), and the levels of serum aspartate aminotransferase. Based on this finding, the authors propose that CD32 expression on T cells could be a biomarker for severity of liver disease in chronic HBV patients.Gut mucosal immunity has historically been a particularly intriguing interest for many in the field of HIV research. In an article by Guo et al., the researchers analyzed intestinal mucosal specimens from the ileocecal region of seven immunological nonresponders (INRs) and measured various immune components. The authors report that INRs had lower Th17 and higher Treg cell counts than did immune responders. The Th17/Treg ratio was compared against other HIV biomarkers and it was concluded that the imbalance of this ratio in the intestine was characteristic of incomplete immune reconstitution after antiretroviral therapy and is associated with intestinal damage.Staying with the topic of immune function in the context of HIV infection, Fusco et al. studied the impact of COVID-19 vaccination on CD4 counts and HIV RNA levels in persons living with HIV. The authors found that for individuals vaccinated with three doses of the mRNA vaccine BNT162b2, asymptomatic/paucisymptomatic COVID-19 did not influence CD4 counts or viral load. Based on these and other observations in their study, the authors concluded that the response to COVID-19 vaccination is effective in people living with HIV.Despite the rapid development of COVID-19 vaccines and their clear benefit at reducing disease severity, the duration of protection from infection afforded by these vaccines was much shorter than we all originally hoped it would be. Breakthrough infections and reinfections were seen for many people ∼6 months after vaccination or infection, and this interval shortened to 2–3 months for infection with Omicron variants. However, neither breakthrough infection nor reinfection suggests a lack of a beneficial immune response, and although the elicited immunity may not have been sufficient to prevent infection, it is clear that an active memory response was playing a critical role in reducing disease severity postvaccination and postinfection.On this topic, Fabiani et al. investigated SARS-CoV-2-specific cellular immune responses in cohorts of individuals who had been COVID-19-vaccinated, SARS-CoV-2-infected, or both (i.e., hybrid immunity) and found that the hybrid immunity cohort showed higher memory B cell (MBC) responses 11 months postinfection than all other groups analyzed. The team also showed that individuals infected with the Delta variant had higher levels of IgM- and IgG-secreting spike-specific MBCs than their counterparts who had been infected with the Omicron variant.This study confirms that although vaccine- or virus-induced immunity may be insufficient at providing long-term protection from infection, the MBC response is present at least 11 months postinfection and would then help to at least reduce severity of disease during subsequent infection.In the bigger picture, as soon as individuals began to become infected with SARS-CoV-2, and even more so after vaccines began to roll out, the question of herd immunity came up. It was soon realized that sterilizing herd immunity was not going to be achieved through natural infection or vaccination due to the rapidly waning antibody levels postinfection and/or postvaccination. Many would argue that we now have established some kind of herd immunity that is contributing to less severe disease overall, and perhaps even preventing some infections, but obviously we do not have the gold standard sterilizing herd immunity that we hope to achieve through vaccination of a sufficient proportion of the population.In an article by DM Asriadi, COVID-19 vaccination was analyzed in five provinces in Indonesia with the goal of determining why some regions experienced low vaccination rates. It was found that the relatively low vaccination rates in the five provinces studied could be attributed to doubt regarding the status of the vaccine, less than optimal information, communication, and education about the vaccine by government, and variations in environment and geography that presented logistical obstacles for vaccine rollout.Globally, the extent of vaccine delivery and acceptance varied widely depending on many issues, including accessibility as well as public opinion. As we reflect on the pandemic, it is interesting to consider that when faced with a new and deadly infectious threat, many individuals chose not to receive life-saving vaccines, and that in some places, governments even chose not to encourage acceptance of these vaccines.In closing, we wish to thank all authors for their outstanding research contributions, all reviewers for volunteering their time to help ensure the quality of work published in our journal, funding sources for making the work possible, and of course to all study subjects for providing crucial samples that help us understand the immune responses against many viruses.Author Disclosure StatementNo competing financial interests exist.Funding InformationNo funding was received.FiguresReferencesRelatedDetails Volume 36Issue 5Jun 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Rodney S. Russell.Immunity in the Presence of Chronic or Repeated Infection.Viral Immunology.Jun 2023.301-302.http://doi.org/10.1089/vim.2023.0073.editorialPublished in Volume: 36 Issue 5: June 14, 2023PDF download