Comparison of T-cell subsets' reconstitution after 12 months of highly active antiretroviral therapy initiated during early versus advanced states ofHIV disease

This research comprised a pilot open prospective clinical study comparing T -cell subset reconstitution in antiretroviral-naive patients, after 12 mont hs of HAART when treatment was initiated in early stages (ES; n = 18) of in fection versus advanced stages (AS; n = 20). Control group: 10 healthy HIV- negative individuals, Immunophenotypic markers were evaluated before and af ter 6- and 12-months' therapy. Functional assays were performed in one subs et. Results: Viral load (VL) was < 200 copies/ml in all patients, Median percen tages of CD4(+) pretherapy were 33% and 6%, respectively, in the ES and AS groups, inclement after 12 months of therapy was +15% and +13% respectively . Only the ES group achieved normal values. Declines of CD8(+) percentage w ere significantly higher in the ES (-18%) than in the AS group (-2%). CD4() memory and naive cells in the ES group were similar to those of controls before treatment and did not change after therapy. In contrast, CD4(+) memo ry and naive cells in the AS group did not leach normal levels despite trea tment. In the ES group, there was a significant increment in CD8+ naive cel ls (+8%) and a decrement in CD8(+)CD38(+) cells (-17%), both populations re ached values close to normal, whereas these subsets remained far from norma l in the AS group. Improvement of lymphoproliferative response after therap y was observed in both groups. One patient in the ES group showed positive LPR against p24 after treatment. After 12 months' highly active antiretroviral therapy, only those who began such therapy in ES disease reached values within the range of healthy cont rols. To achieve a more complete immunologic reconstitution, early initiati on of potent antiretroviral therapy should be recommended.