Plasmodium inui Infection Reduces the Efficacy of a Simian Immunodeficiency Virus DNA Vaccine in a Rhesus Macaque Model Through Alteration of the Vaccine-Induced Immune Response

Human immunodeficiency virus type 1 and malaria are co-endemic in many areas. We evaluated the effects of Plasmodium inui infection on the performance of a simian immunodeficiency virus (SIV) DNA vaccine. Rhesus macaques were infected with P. inui by transfusion of whole blood from a persistently infected animal. Animals with and animals without P. inui infection were then vaccinated 4 times with an SIV DNA vaccine encoding SIVgag, SIVpol, and SIVenv. Animals were subsequently challenged with thirty 50% rhesus monkey infectious doses of SIVmac251 6 weeks after the last vaccination. P. inui–infected immunized animals showed a significantly higher viral load than animals without P. inui infection (P = .010, by the Wilcoxon rank sum test). The higher viral loads in the P. inui–infected animals were durable and were observed at all sampling time points across the study (P = .00245, by the Wilcoxon rank test). The P. inui–infected animals also had correspondingly lower CD4+ cell counts. There were fewer vaccine-specific CD4+ and CD8+ cells in the P. inui–infected animals, compared with uninfected animals. Of importance, P. inui infection seemed to decrease the number of CD8+ cells that could proliferate or secrete interferon γ, although the number of CD8+ cells capable of secreting tumor necrosis factor α following in vitro stimulation was increased. This study demonstrated that P. inui infection had an influence on the immune response to an SIV DNA vaccine and decreased the vaccine's efficacy.