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Changes in levels of T cell subpopulations to monitor the response to antiretroviral therapy among HIV-1-infected patients during two years of HIV-1 replication suppression.
- Source :
- Scandinavian Journal of Infectious Diseases; May2013, Vol. 45 Issue 5, p368-377, 10p
- Publication Year :
- 2013
-
Abstract
- Objectives: The aim of this study was to compare the effect of 2 y of antiretroviral therapy (ART) on the percentage of activated CD38<superscript>+</superscript>CD8<superscript>+</superscript> T cells and human leukocyte antigen (HLA)-DR<superscript>+</superscript>CD8<superscript>+</superscript> T cells, and the expression of the co-stimulatory molecule CD28 on CD4<superscript>+</superscript> and CD8<superscript>+</superscript> T cells in the peripheral blood of HIV-infected adults, and to assess the use of immune activation markers to predict the virological response to ART in a cohort of HIV-1-infected patients in the north-western part of China. Methods: We analyzed changes in the CD4<superscript>+</superscript> T cell count, viral load, and the percentages of CD38<superscript>+</superscript>CD8<superscript>+</superscript> T cells, HLA-DR<superscript>+</superscript>CD8<superscript>+</superscript> T cells, CD28<superscript>+</superscript>CD4<superscript>+</superscript> T cells, and CD28<superscript>+</superscript>CD8<superscript>+</superscript> T cells in 48 patients with HIV diseases during 2 y of suppressive highly active antiretroviral therapy (HAART). Good virological responders ( n = 20) were defined as those who had suppressed and maintained a plasma viral load below the detection limit of the assay for at least 12 months. Poor virological responders ( n = 28) were defined as those with a detectable viral load at 6 and 12 months after beginning HAART. Results: Among the 20 good responders, baseline median levels of CD38<superscript>+</superscript>CD8<superscript>+</superscript> T cells were elevated, but had decreased significantly at 24 months of therapy ( p < 0.0001). Median levels of HLA-DR<superscript>+</superscript>CD8<superscript>+</superscript> T cells also decreased at 24 months of therapy ( p < 0.0001). Levels of expression of CD28<superscript>+</superscript>CD4<superscript>+</superscript> T cells rose steadily to 6 months ( p = 0.03), and smoothly reached levels observed among HIV-negative blood donors during the 24 months of therapy ( p > 0.05). Levels of expression of CD28<superscript>+</superscript>CD8<superscript>+</superscript> T cells increased at 24 months ( p = 0.04). Among the 28 poor responders, median levels of CD38<superscript>+</superscript>CD8<superscript>+</superscript> T cells decreased significantly at 24 months ( p < 0.0001). Levels of HLA-DR<superscript>+</superscript>CD8<superscript>+</superscript> T cells also decreased at 24 months ( p < 0.001). Levels of CD28<superscript>+</superscript>CD8<superscript>+</superscript> T cells and levels of CD28<superscript>+</superscript>CD4<superscript>+</superscript> T cells increased at 24 months remained unchanged. The percentage of CD38<superscript>+</superscript>CD8<superscript>+</superscript> T cells appeared to provide a sensitive estimate of the overall immune recovery in comparison with the percentage of HLA-DR<superscript>+</superscript>CD8<superscript>+</superscript> T cells, although this lacked specificity for the determination of early virological drug failure and did not appear to be a reliable surrogate for RNA viral load. Conclusions: We show that HAART can be used successfully in Chinese populations with elevated baseline immune activation markers and that the percentage of CD38<superscript>+</superscript>CD8<superscript>+</superscript> T cells may be an additional parameter to the current criteria for estimating the antiretroviral response with HAART. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00365548
- Volume :
- 45
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Scandinavian Journal of Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 86976055
- Full Text :
- https://doi.org/10.3109/00365548.2012.744465