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Long-lasting recovery in CD4 T-cell function and viral-load reduction after highly active antiretroviral therapy in advanced HIV-1 disease.
- Source :
-
Lancet . 6/6/1998, Vol. 351 Issue 9117, p1682-1686. 5p. 1 Chart, 7 Graphs. - Publication Year :
- 1998
-
Abstract
- <bold>Background: </bold>Highly active antiretroviral therapy (HAART) decreases viral load and increases CD4 T-cell counts in patients with advanced HIV-1 infection. Whether HAART can improve CD4 T-cell function, and the biological characteristics affecting immune reconstitution, remain unclear. We undertook an open prospective pilot study to address these issues. Both treatment-naïve and previously treated patients were included.<bold>Methods: </bold>20 patients (seven naïve, 13 previously treated) were treated with one protease inhibitor and two reverse-transcriptase inhibitors and followed up for 12 months. We measured CD4-cell proliferation in response to cytomegalovirus and tuberculin antigens and counted subsets of CD4 cells at baseline and months 1, 3, 6, 9, and 12. Patients who had no antigen-specific reactivity at baseline but developed it while receiving HAART were classified as immunological responders.<bold>Findings: </bold>Four patients had antigen-specific reactivity at baseline compared with 14 at month 12 (p <0.001). Between month 3 and month 12 viral load fell by a median of 1.5 log copies/mL from baseline (4.6 log copies/mL) and CD4-cell count increased by a median of 63/microL (from 93/microL). Ten patients (six of seven naïve, four of 13 previously treated) were immunological responders. They differed significantly from the ten non-responders in that their viral-load reduction was sustained for 12 months, the increase in CD4 count was greater, and they showed an early increase in memory CD4 T cells with an increase of naïve T cells.<bold>Interpretation: </bold>HAART can induce sustained recovery of CD4 T-cell reactivity against opportunistic pathogens in severely immunosuppressed patients. This recovery depends not on baseline values but on the amplitude and duration of viral-load reduction and the increase of memory CD4 T cells. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HIV infections
*THERAPEUTICS
*CD4 antigen
*THERAPEUTIC use of protease inhibitors
*T cells
*ANTI-HIV agents
*RNA analysis
*REVERSE transcriptase inhibitors
*INDINAVIR
*RITONAVIR
*CELL division
*COMPARATIVE studies
*HIV
*IMMUNE response
*IMMUNOCOMPETENT cells
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*MONOCLONAL antibodies
*RESEARCH
*TIME
*PILOT projects
*VIRAL load
*EVALUATION research
*PHYSIOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 01406736
- Volume :
- 351
- Issue :
- 9117
- Database :
- Academic Search Index
- Journal :
- Lancet
- Publication Type :
- Academic Journal
- Accession number :
- 688443
- Full Text :
- https://doi.org/10.1016/S0140-6736(97)10291-4