Highly active anti-retroviral therapy (HAART) is associated with a lower level of CD4(+) T cell apoptosis in HIV-infected patients

HAART may increase CD4(+) T cell counts despite a persistently detectable H IV load. The impact of HAART on apoptosis, which may play a role in the dis ease process in HIV-infected patients, has not been extensively studied. We performed a study to compare the level of spontaneous T cell apoptosis and anti-retroviral treatments in a cohort of HIV-1-infected patients. Data we re obtained from a computerized medical record. Quantification of apoptotic cells was by cytofluorometric technique. From November 1995 to December 19 97 we studied T cell apoptosis in 112 HIV-infected patients. Forty patients were classified A, 36 B and 36 C. Thirty patients were naive and 82 receiv ed an anti-retroviral treatment, 49 including a protease inhibitor (PI). Th e median plasma viraemia determined in 63 patients was 3.6 (range 1.3-5.6) log(10). The median apoptotic cell count was 22% (range 2-73%) and 12% (ran ge 2-60%) for CD4(+) and CD8(+) T cells, respectively. We did not observe a ny correlation between the HIV viraemia and the level of apoptosis of T cel l subsets. Patients with HAART showed a lower percentage of apoptotic CD4() T cells only: 16% (range 2-61%) versus 25% (range 5-73%) for patients rec eiving two nucleoside analogues (P = 0.02). This effect was significant in stage A patients and remained observable during the whole course of HIV dis ease. In conclusion, HAART, without any relation to plasma viraemia, is abl e to reduce apoptosis of CD4(+) T cells.