Reduction of immune system activation in HIV-1-infected patients undergoing highly active antiretroviral therapy

The aim of this work was to analyze the effects of highly active antiretrov iral therapy on the chronically activated immune system of 26 antiretrovira l-naive HIV-l-infected patients. Samples from baseline to week 24 or 36 of treatment were tested for serum levels of beta 2-microglobulin, tumor necro sis factor alpha and soluble tumor necrosis factor alpha receptor type II, as well as for human leukocyte antigen-DR expression on T cells. After star ting therapy, the mean HIV-1 RNA serum levels decreased and the mean CD4+ c ell counts increased from baseline to week 36 (P < 0.001). Mean levels of t umor necrosis factor alpha receptor type II, tumor necrosis factor alpha an d beta 2-microglobulin as well as expression of human leukocyte antigen-DR were significantly reduced at the end of follow-up (P < 0.01). Deactivation kinetics of these parameters was similar in patients with CD4+ counts>200c ells/mu l at baseline versus those with CD4+ counts <200 cells/mu l at base line, despite higher activation at baseline in the group with <200 cells/mu l. In summary, this study shows that highly active antiretroviral therapy is able to induce a strong deactivation of the immune system of HIV-1-infec ted patients.