Long-term evaluation of T-cell subsets and T-cell function after HAART in advanced stage HIV-1 disease

Citation
I. Mezzaroma et al., Long-term evaluation of T-cell subsets and T-cell function after HAART in advanced stage HIV-1 disease, AIDS, 13(10), 1999, pp. 1187-1193
Citations number
28
Categorie Soggetti
Immunology
Journal title
AIDS
ISSN journal
02699370 → ACNP
Volume
13
Issue
10
Year of publication
1999
Pages
1187 - 1193
Database
ISI
SICI code
0269-9370(19990709)13:10<1187:LEOTSA>2.0.ZU;2-V
Abstract
Objectives: Evaluation of immunological reconstitution after 2 years of hig hly active antiretroviral therapy (HAART) in AIDS patients. Design: Previous data showed the effectiveness of HAART but conflicting evi dence of immune reconstitution has been found in severely immunocompromised patients. Therefore, T-cell subsets and functions were analysed during 24 months of HAART in 21 AIDS patients (mean baseline CD4 cell count, 20 x 10( 6)/l). Methods: Subjects were tested at baseline and after 4, 12 and 24 months of therapy for clinical symptoms and the following investigations were carried out: plasma HIV RNA, T-cell subsets and lymphoproliferative responses to m itogens (phytohaemagglutinin, anti-CD3), and recall antigens (Candida manno protein, tetanus toroid and recombinant glycoprotein 160). Results: Increase in body weight, improvement of Karnofsky's score and redu ction of opportunistic infections were observed. All patients showed an ini tial increase in the CD4 memory subset, whereas naive CD4 cells consistentl y increased only after 1 year. The magnitude of immune recovery was stronge r in patients showing a significant reduction in viral load. However seven out of 21 patients who did not reach a sustained suppression of viral load showed also an increase in T-cell subsets. The majority of patients recover ed lymphoproliferative responses to mitogens, whereas only four subjects sh owed a functional response to Candida mannoprotein. No patients showed a re sponse to HIV recombinant glycoprotein 160 or tetanus toroid. Conclusions: The immune recovery observed is slower and not complete in sev erely immunocompromised patients. Our data suggest that HAART may be contin ued also in the absence of a significant HIV RNA decrease if alternative dr ugs are not available. (C) 1999 Lippincott Williams & Wilkins.