Incomplete reconstitution of T cell subsets on combination antiretroviral therapy in the AIDS Clinical Trials Group protocol 384.

TitleIncomplete reconstitution of T cell subsets on combination antiretroviral therapy in the AIDS Clinical Trials Group protocol 384.
Publication TypeJournal Article
Year of Publication2009
AuthorsRobbins GK, Spritzler JG, Chan ES, Asmuth DM, Gandhi RT, Rodriguez BA, Skowron G, Skolnik PR, Shafer RW, Pollard RB
Corporate AuthorsAIDS Clinical Trials Group 384 Team
JournalClin Infect Dis
Volume48
Issue3
Pagination350-61
Date Published2009 Feb 1
ISSN1537-6591
KeywordsAcquired Immunodeficiency Syndrome, Adult, Antiretroviral Therapy, Highly Active, B-Lymphocytes, CD4 Lymphocyte Count, CD4-CD8 Ratio, Female, Humans, Killer Cells, Natural, Male, Middle Aged, T-Lymphocyte Subsets
Abstract

BACKGROUND: Initiation of combination antiretroviral therapy (ART) results in higher total CD4 cell counts, a surrogate for immune reconstitution. Whether the baseline CD4 cell count affects reconstitution of immune cell subsets has not been well characterized.

METHODS: Using data from 978 patients (621 with comprehensive immunological assessments) from the AIDS [Acquired Immunodeficiency Syndrome] Clinical Trials Group protocol 384, a randomized trial of initial ART, we compared reconstitution of CD4(+), CD4(+) naive and memory, CD4(+) activation, CD8(+), CD8(+) activation, B, and natural killer cells among patients in different baseline CD4(+) strata. Reference ranges for T cell populations in control patients negative for human immunodeficiency virus (HIV) infection were calculated using data from AIDS Clinical Trials Group protocol A5113.

RESULTS: Patients in the lower baseline CD4(+) strata did not achieve total CD4(+) cell counts similar to those of patients in the higher strata during 144 weeks of ART, although CD4(+) cell count increases were similar. Ratios of CD4(+) naive-memory cell counts and CD4(+):CD8(+) cell counts remained significantly reduced in patients with lower baseline CD4(+) cell counts (

CONCLUSIONS: After nearly 3 years of ART, T cell subsets in patients with baseline CD4(+) cell counts >350 cells/mm(3) achieved or approached the reference range those of control individuals without HIV infection. In contrast, patients who began ART with

DOI10.1086/595888
Alternate JournalClin. Infect. Dis.
PubMed ID19123865
PubMed Central IDPMC2676920
Grant ListAI066992 / AI / NIAID NIH HHS / United States
AI25879 / AI / NIAID NIH HHS / United States
AI27659 / AI / NIAID NIH HHS / United States
AI27666 / AI / NIAID NIH HHS / United States
AI38855 / AI / NIAID NIH HHS / United States
AI38858 / AI / NIAID NIH HHS / United States
IP30AI060354 / AI / NIAID NIH HHS / United States
K01 AI062435 / AI / NIAID NIH HHS / United States
K01 AI062435-01A1 / AI / NIAID NIH HHS / United States
K01 AI062435-02 / AI / NIAID NIH HHS / United States
K01 AI062435-03 / AI / NIAID NIH HHS / United States
K01 AI062435-04 / AI / NIAID NIH HHS / United States
K01AI062435 / AI / NIAID NIH HHS / United States