Immune Activation While on Potent Antiretroviral Therapy Can Predict Subsequent CD4+ T-Cell Increases Through 15 Years of Treatment.

TitleImmune Activation While on Potent Antiretroviral Therapy Can Predict Subsequent CD4+ T-Cell Increases Through 15 Years of Treatment.
Publication TypeJournal Article
Year of Publication2013
AuthorsZhang X, Hunt PW, Hammer SM, Cespedes MS, Patterson KB, Bosch RJ
JournalHIV Clin Trials
Volume14
Issue2
Pagination61-7
Date Published2013 Mar-Apr
ISSN1528-4336
KeywordsAdult, Anti-HIV Agents, CD4 Lymphocyte Count, CD8-Positive T-Lymphocytes, Female, HIV Infections, Humans, Lymphocyte Activation, Male, Middle Aged
Abstract

BACKGROUND: While persistent T-cell activation has been cross-sectionally associated with poor CD4+ T-cell restoration in HIV-infected individuals maintaining antiretroviral treatment (ART)-mediated viral suppression, it remains unclear whether CD8+ T-cell activation is of predictive effect on CD4+ T-cell recovery.

OBJECTIVE: We assessed whether the extent of persistent CD8+ T-cell activation (% CD38+/HLA-DR+) in the first few years of ART-mediated viral suppression predicted subsequent CD4+ T-cell recovery in 95 subjects with up to 15 years of observation on suppressive ART.

RESULTS: Lower CD8+ T-cell activation and higher naïve CD4+ T-cell frequencies (CD45RA+/CD62L+) measured at year 3 to 5 after starting ART independently predicted greater subsequent CD4+ T-cell increases. The mean CD4 count increase from year 0 to year 5 and the increase to the average of year 10 to 15 in the low CD8 activation group (≤18.5%; mean = 13%) were 342 and 458 cells/mm,3 and the increases were 248 and 349 cells/mm3 for the high CD8 activation group (≯18.5%; mean = 29%) (P = .002 and P = .016, respectively, comparing groups). At years 10 to 15, the mean CD4 counts in the groups were 579 and 484 cells/mm3, respectively (P = .026).

CONCLUSION: These findings support the need to identify approaches to reduce immune activation in treated HIV disease.

DOI10.1310/hct1402-61
Alternate JournalHIV Clin Trials
PubMed ID23611826
PubMed Central IDPMC3788605
Grant ListAI 069740 / AI / NIAID NIH HHS / United States
AI 38855 / AI / NIAID NIH HHS / United States
AI 38858 / AI / NIAID NIH HHS / United States
AI 68634 / AI / NIAID NIH HHS / United States
AI 68636 / AI / NIAID NIH HHS / United States
RR 024156 / RR / NCRR NIH HHS / United States
U01 AI038855 / AI / NIAID NIH HHS / United States
U01 AI038858 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI069470 / AI / NIAID NIH HHS / United States
UL1 RR024156 / RR / NCRR NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States