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Changes in levels of T cell subpopulations to monitor the response to antiretroviral therapy among HIV-1-infected patients during two years of HIV-1 replication suppression.
MedLine Citation:
PMID:  23186319     Owner:  NLM     Status:  Publisher    
Objectives: The aim of this study was to compare the effect of 2 y of antiretroviral therapy (ART) on the percentage of activated CD38(+)CD8(+) T cells and human leukocyte antigen (HLA)-DR(+)CD8(+) T cells, and the expression of the co-stimulatory molecule CD28 on CD4(+) and CD8(+) T cells in the peripheral blood of HIV-infected adults, and to assess the use of immune activation markers to predict the virological response to ART in a cohort of HIV-1-infected patients in the north-western part of China. Methods: We analyzed changes in the CD4(+) T cell count, viral load, and the percentages of CD38(+)CD8(+) T cells, HLA-DR(+)CD8(+) T cells, CD28(+)CD4(+) T cells, and CD28(+)CD8(+) T cells in 48 patients with HIV diseases during 2 y of suppressive highly active antiretroviral therapy (HAART). Good virological responders (n = 20) were defined as those who had suppressed and maintained a plasma viral load below the detection limit of the assay for at least 12 months. Poor virological responders (n = 28) were defined as those with a detectable viral load at 6 and 12 months after beginning HAART. Results: Among the 20 good responders, baseline median levels of CD38(+)CD8(+) T cells were elevated, but had decreased significantly at 24 months of therapy (p < 0.0001). Median levels of HLA-DR(+)CD8(+) T cells also decreased at 24 months of therapy (p < 0.0001). Levels of expression of CD28(+)CD4(+) T cells rose steadily to 6 months (p = 0.03), and smoothly reached levels observed among HIV-negative blood donors during the 24 months of therapy (p > 0.05). Levels of expression of CD28(+)CD8(+) T cells increased at 24 months (p = 0.04). Among the 28 poor responders, median levels of CD38(+)CD8(+) T cells decreased significantly at 24 months (p < 0.0001). Levels of HLA-DR(+)CD8(+) T cells also decreased at 24 months (p < 0.001). Levels of CD28(+)CD8(+) T cells and levels of CD28(+)CD4(+) T cells increased at 24 months remained unchanged. The percentage of CD38(+)CD8(+) T cells appeared to provide a sensitive estimate of the overall immune recovery in comparison with the percentage of HLA-DR(+)CD8(+) T cells, although this lacked specificity for the determination of early virological drug failure and did not appear to be a reliable surrogate for RNA viral load. Conclusions: We show that HAART can be used successfully in Chinese populations with elevated baseline immune activation markers and that the percentage of CD38(+)CD8(+) T cells may be an additional parameter to the current criteria for estimating the antiretroviral response with HAART.
Jiu-Cong Zhang; Hong-Jun Zhang; Yuan Li; Dan Jing; Qing Liu; Ke Zhao; Qing-Quan Liu; Yan Zhuang; Wen-Zhen Kang; Yong-Tao Sun
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-28
Journal Detail:
Title:  Scandinavian journal of infectious diseases     Volume:  -     ISSN:  1651-1980     ISO Abbreviation:  Scand. J. Infect. Dis.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215333     Medline TA:  Scand J Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University , Xi'an , China.
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