Reduction in T cell apoptosis in patients with HIV disease following antiretroviral therapy

Patients with HIV infection manifest increased T lymphocyte apoptosis, This study investigated the influence of antiretroviral therapy (ART) upon lymp hocyte apoptosis in 23 HIV-infected adults naive to protease inhibitors. Pa tients were enrolled in a treatment trial consisting of Nelfinavir (NFV), d 4T, or NFV + d4T for 24 weeks, followed by triple therapy (NFV + reverse tr anscriptase inhibitors) for an additional 24 weeks. Spontaneous T cell apop tosis in cultured PBMC decreased by 23.67 +/- 18.2% (P < 0.006) at 48 weeks and plasma HIV RNA decreased by 1.79 +/- 0.59 log,, RNA copies/ml (P < 0.0 01). The absolute decrease and slope of T cell apoptosis correlated with pl asma virus load and with activated CD8 T cells and was inversely correlated with CD4 T cells. We conclude that reduction in chronic antigenic stimulat ion and the absence of cellular signals elicited by viral products contribu te to the rescue of T lymphocytes from apoptosis, which facilitates immunol ogic recovery in ART-treated patients. (C) 1999 Academic Press.