RANTES production by T cells and CD8-mediated inhibition of human immunodeficiency virus gene expression before initiation of potent antiretroviral therapy predict sustained suppression of viral replication

A prospective blinded study was conducted to determine whether immunologica l differences exist between patients receiving potent antiretroviral therap y who are able to achieve and maintain an undetectable virus load (<50 copi es/mL) and those who are not. Eleven patients receiving protease inhibitor- containing antiretroviral therapy were studied for 1 year. After analysis o f all baseline samples, patient virus load was disclosed, and patients were classified as suppressors (those who maintained undetectable virus load fo r 1 year) and nonsuppressors, Baseline virus load and CD4(+) T cell count d id not differ significantly between the 2 groups. Levels of RANTES producti on by CD4(+) and CD8(+) T cells and CD8-mediated inhibition of human immuno deficiency virus type 1 gene expression before initiation of antiretroviral therapy were significantly associated with an undetectable virus load main tained for 1 year (P<.05), Thus, a functionally intact T cell-mediated immu ne system at the time of initiation of potent antiretroviral therapy may pr edict long-term virus suppression.