Persistent viral load in patients on HAART is associated with a higher level of activation-induced apoptosis of CD4(+) T cells

Apoptosis is one of the mechanisms involved in the persistent CD4(+) T cell lymphopenia occurring in human Immunodeficiency virus (HIV)-infected patie nts treated with highly active antiretroviral therapy (HAART). The aim of t his study was to look at the relationship between the level of T cell apopt osis in patients on HAART and their HIV viral load measurement. Forty-five patients receiving HAART for a median time of 5 months were included: 13 ha d an undetectable viral load and 32 had a viral load greater than or equal to 200 copies/mL. No relationship was observed between the level of spontan eous T cell apoptosis and the viral load measurement. Patients with a viral load greater than or equal to 200 copies/mL exhibited a significantly high er level of CD4-induced apoptosis of CD4+ T cells, compared with patients w ith undetectable viraemia (38 versus 15%, respectively, P = 0.03). Activati on-induced apoptosis may be involved in the paucity of the immune reconstit ution observed in HIV-infected patients treated with HAART.