Long-Term Evaluation of T-Cell Subset Changes After Effective Combination Antiretroviral Therapy During Asymptomatic HIV-Infection
作者:
Leslie Bisset,
Richard Cone,
Marek Fischer,
Manuel Battegay,
Pietro Vernazza,
Rolf Dubs,
Rainer Weber,
Peter Grob,
Milos Opravil,
期刊:
JAIDS Journal of Acquired Immune Deficiency Syndromes
(OVID Available online 2001)
卷期:
Volume 27,
issue 3
页码: 266-271
ISSN:1525-4135
年代: 2001
出版商: OVID
关键词: HIV-1;Asymptomatic;Antiretroviral therapy;T-cell subsets
数据来源: OVID
摘要:
Demonstration of long-lived HIV-reservoirs resistant to the effects of combination antiretroviral therapy raises concern over the ability of treatment to maintain long-term beneficial alterations in T-cell subset composition. To address this issue, we have examined the effect of antiretroviral therapy on T-cell subset change during early HIV-infection in a 2-year prospective open-label trial composed of treatment-naive asymptomatic HIV-infected patients with CD4+T-cell counts ≥400 cells/&mgr;l. Therapy consisted of double (zidovudine and lamivudine) or triple (zidovudine, lamivudine, and ritonavir) combination antiretroviral therapy. Retrospective analysis based on magnitude of viral suppression was used to characterize responder and nonresponder groups. Among responders, long-term antiretroviral therapy maintained a significant increase in numbers of total CD4+, naive CD4+/CD45RA+, and memory CD4+/CD45RO+T cells. A concomitant significant decrease in numbers of memory CD8+/CD45RO+and both activated CD8+/HLA-DR+and CD8+/CD38+T cells was also maintained. In contrast, long-term antiretroviral therapy among nonresponders led only to a significant increase in the numbers of CD4+T cells and a significant reduction in numbers of activated CD8+/HLA-DR+T cells. The long-term ability of antiretroviral therapy during early asymptomatic HIV-infection to maintain reversal of disease-induced T-cell activation and maturation abnormalities continues to support the concept that immunologic advantage is gained by commencing early aggressive antiretroviral therapy. Nevertheless, continued management of T-cell subset recovery is significantly more effective in the presence of completely suppressed viral replication.
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