Spontaneous apoptosis and highly active antiretroviral therapy (HAART)

Increased programmed cell death (PCD) or apoptosis has been detected in the T cells of HIV-infected subjects; it is held partially responsible for the continuous loss of CD4+ T cells during the natural course of If IV infecti on. Highly active antiretroviral therapy (HAART) decreases the viral load a nd leads to an increase of CD4+ count in vivo. In this study we evaluated P CD in total peripheral blood mononuclear cells, CD8+ and CD4+ lymphocytes b efore and four weeks after initiation of HAART. Seven HIV-1-infected patien ts were investigated. Viral load was assessed by RT-polymerase chain reacti on and PCD by now cytometry using apoptosis by 7 amino actinomycin D (7AAD) and propidium iodide (PI). After four weeks of HAART. CD4+ T and CD8+ T ce ll levels were stable, and plasma HIV-RNA; copies were significantly decrea sed. In four of the patients (4/7). HIV-RNA levels were reduced to undetect able levels (fewer than 400 copies per milliliter). A statistically signifi cant reduction of apoptosis among CD4+ cells was observed (P < 0.03), thoug h neither in the CD8+ T cell population nor in peripheral blood mononuclear cells (PDMCS), These results demonstrate the beneficial effect of HAART on apoptosis of CD4+ cells in the early treatment stage. (C) 2000 Editions sc ientifiques: ct medicales Elsevier SAS.