Cm. Mastroianni et al., Improvement in neutrophil and monocyte function during highly active antiretroviral treatment of HIV-1-infected patients, AIDS, 13(8), 1999, pp. 883-890
Objective: To investigate the effect of highly active antiretroviral treatm
ent (HAART) on neutrophil and monocyte function in patients with moderately
advanced HIV-1 infection.
Design: Eighteen HIV-1-infected patients with CD4 T cell counts below 350/m
u l, no concomitant active infection, and no previous use of protease inhib
itors were treated with indinavir or ritonavir and two reverse-transcriptas
e inhibitors and were followed up for 9 months. Ten age- and sex-matched he
althy subjects were included as controls.
Methods: The functional activity of neutrophils and monocytes was measured
by assessing chemotaxis towards a bacterial peptide, killing activity again
st Candida albicans, and oxidative burst as measured by chemiluminescence p
roduction.
Results: Neutrophils and monocytes from the treatment group exhibited a sig
nificantly diminished baseline chemotactic and fungicidal activity compared
with healthy controls (P < 0.001). After starting HAART, there was a signi
ficant improvement in chemotaxis and fungicidal activity of phagocytic cell
s (P < 0.001). Values of chemotaxis reached normal ranges in 13 out of 18 p
atients (72%) for neutrophils and eight out of 18 (44%) for monocytes, wher
eas phagocyte killing was rarely restored to normal values (3/18 cases for
monocytes and 0/18 for neutrophils). The administration of HAART was also a
ssociated with significantly increased phagocyte chemiluminescence producti
on in response to phorbol-12-myristate 13-acetate or opsonized C. albicans
(P < 0.01).
Conclusion: The functional improvement of two critical components of innate
antimicrobial immunity, such as neutrophils and monocytes, may contribute
to the improved cell-mediated immune responses against opportunistic infect
ions in HAART-treated patients. (C) 1999 Lippincott Williams & Wilkins.