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.
Scand J Infect Dis
; 45(5): 368-77, 2013 May.
Article
em En
| MEDLINE
| ID: mdl-23186319
ABSTRACT
OBJECTIVES:
The aim of this study was to compare the effect of 2 y of antiretroviral therapy (ART) on the percentage of activated CD38âºCD8⺠T cells and human leukocyte antigen (HLA)-DRâºCD8⺠T cells, and the expression of the co-stimulatory molecule CD28 on CD4⺠and CD8⺠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⺠T cell count, viral load, and the percentages of CD38âºCD8⺠T cells, HLA-DRâºCD8⺠T cells, CD28âºCD4⺠T cells, and CD28âºCD8⺠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 CD38âºCD8⺠T cells were elevated, but had decreased significantly at 24 months of therapy (p < 0.0001). Median levels of HLA-DRâºCD8⺠T cells also decreased at 24 months of therapy (p < 0.0001). Levels of expression of CD28âºCD4⺠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 CD28âºCD8⺠T cells increased at 24 months (p = 0.04). Among the 28 poor responders, median levels of CD38âºCD8⺠T cells decreased significantly at 24 months (p < 0.0001). Levels of HLA-DRâºCD8⺠T cells also decreased at 24 months (p < 0.001). Levels of CD28âºCD8⺠T cells and levels of CD28âºCD4⺠T cells increased at 24 months remained unchanged. The percentage of CD38âºCD8⺠T cells appeared to provide a sensitive estimate of the overall immune recovery in comparison with the percentage of HLA-DRâºCD8⺠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 CD38âºCD8⺠T cells may be an additional parameter to the current criteria for estimating the antiretroviral response with HAART.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Linfócitos T CD4-Positivos
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Infecções por HIV
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Subpopulações de Linfócitos T
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HIV-1
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Linfócitos T CD8-Positivos
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Antirretrovirais
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article