Incomplete CD4 T cell recovery in HIV-1 infection after 12 months of highly active antiretroviral therapy is associated with ongoing increased CD4 T cell activation and turnover.
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| Abstract |
To evaluate the relationship between T cell turnover, immune activation, and CD4 recovery in HIV infection, 32 antiretroviral-naive HIV-1-infected patients were studied before and after initiation of highly active antiretroviral therapy (HAART). Elevated CD4 and CD8 T cell turnover (measured by Ki67) in HIV infection decreased with HAART in blood and lymphoid tissue. Increased peripheral CD4 T cell turnover was strongly associated with immune activation even after viral suppression to less than 50 copies/mL (R = 0.8; p <.001). Increased CD4 T cell turnover correlated strongly with CD4 cell counts both before (R = -0.6; p <.001) and after (R = -0.4; p =.05) HAART. In patients with baseline CD4 cell counts of less than 350/microL, decreases in CD4 T cell turnover with HAART significantly correlated with increases in CD4 cell counts. In addition, persistently elevated levels of CD4 T cell turnover after HAART were associated with incomplete CD4 T cell recovery despite HIV RNA levels of less than 50 copies/mL. These data suggest that immune activation is central to CD4 cell depletion in HIV infection and immune reconstitution with HAART.
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| Authors | Kara B Anthony, Christian Yoder, Julia A Metcalf, Rebecca DerSimonian, Jan M Orenstein, Randy A Stevens, Judy Falloon, Michael A Polis, H Clifford Lane, Irini Sereti |
| Journal | Journal of acquired immune deficiency syndromes (1999) (J Acquir Immune Defic Syndr) Vol. 33 Issue 2 Pg. 125-33 (Jun 01 2003) ISSN: 1525-4135 [Print] United States |
| PMID | 12794543 (Publication Type: Comparative Study, Journal Article, Research Support, U.S. Gov't, P.H.S.) |
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