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Determinants of CD4+ T cell recovery during suppressive antiretroviral therapy: association of immune activation, T cell maturation markers, and cellular HIV-1 DNA.
J Infect Dis. 2006 Jul 01; 194(1):29-37.JI

Abstract

BACKGROUND

Suboptimal CD4+ T cell recovery during antiretroviral therapy (ART) is a common clinical dilemma.

METHODS

We analyzed viral and immunologic predictors of CD4+ T cell recovery in 116 human immunodeficiency virus type 1 (HIV-1)-infected subjects who had suppressed viremia (< or = 50 copies/mL) while receiving ART. Successive measurements of T cell immunophenotypes and cellular HIV-1 DNA levels were obtained before and during receipt of ART. On the basis of increases in the CD4+ T cell count, subjects were classified as immunologically concordant (demonstrating an increase of > or = 100 CD4+ T cells/mm3) or discordant (demonstrating an increase of <100 CD4+ T cells/mm3) after 48 weeks of ART.

RESULTS

In adjusted analyses, CD4+ and CD8+ T cell activation at baseline was negatively associated with immunologic concordance at week 48 of ART (odds ratio [OR], 0.80 [P = .04] and 0.67 [P = .02], respectively). High memory (CDRA(-)CD62L-) CD8+ T cell counts at baseline (OR, 0.33 [P = .05]) predicted less CD4+ T cell recovery, whereas increased naive CD4+ T cell counts were associated with higher increases in CD4+ T cells (OR, 1.19 [P = .052]). Neither the cell-associated HIV-1 DNA level at baseline (P = .32) nor the cell-associated HIV-1 DNA level at week 48 of ART (P = .42) was associated with immunologic concordance during ART.

CONCLUSIONS

These results support the potential clinical usefulness of the baseline determination of immune activation and maturation subsets in the prediction of CD4+ T cell recovery during viral suppression. Furthermore, identification of individuals with reduced potential for CD4+ T cell recovery during ART may provide a rationale for the initiation of early therapy for some patients.

Authors+Show Affiliations

Department of Medicine, University of California, San Diego, Antiviral Antiviral Research Center, 92131 . mgoicoechea@ucsd.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16741879

Citation

Goicoechea, Miguel, et al. "Determinants of CD4+ T Cell Recovery During Suppressive Antiretroviral Therapy: Association of Immune Activation, T Cell Maturation Markers, and Cellular HIV-1 DNA." The Journal of Infectious Diseases, vol. 194, no. 1, 2006, pp. 29-37.
Goicoechea M, Smith DM, Liu L, et al. Determinants of CD4+ T cell recovery during suppressive antiretroviral therapy: association of immune activation, T cell maturation markers, and cellular HIV-1 DNA. J Infect Dis. 2006;194(1):29-37.
Goicoechea, M., Smith, D. M., Liu, L., May, S., Tenorio, A. R., Ignacio, C. C., Landay, A., & Haubrich, R. (2006). Determinants of CD4+ T cell recovery during suppressive antiretroviral therapy: association of immune activation, T cell maturation markers, and cellular HIV-1 DNA. The Journal of Infectious Diseases, 194(1), 29-37.
Goicoechea M, et al. Determinants of CD4+ T Cell Recovery During Suppressive Antiretroviral Therapy: Association of Immune Activation, T Cell Maturation Markers, and Cellular HIV-1 DNA. J Infect Dis. 2006 Jul 1;194(1):29-37. PubMed PMID: 16741879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determinants of CD4+ T cell recovery during suppressive antiretroviral therapy: association of immune activation, T cell maturation markers, and cellular HIV-1 DNA. AU - Goicoechea,Miguel, AU - Smith,Davey M, AU - Liu,Lin, AU - May,Susanne, AU - Tenorio,Allan R, AU - Ignacio,Caroline C, AU - Landay,Alan, AU - Haubrich,Richard, Y1 - 2006/05/18/ PY - 2005/12/14/received PY - 2006/02/23/accepted PY - 2006/6/3/pubmed PY - 2006/8/8/medline PY - 2006/6/3/entrez SP - 29 EP - 37 JF - The Journal of infectious diseases JO - J Infect Dis VL - 194 IS - 1 N2 - BACKGROUND: Suboptimal CD4+ T cell recovery during antiretroviral therapy (ART) is a common clinical dilemma. METHODS: We analyzed viral and immunologic predictors of CD4+ T cell recovery in 116 human immunodeficiency virus type 1 (HIV-1)-infected subjects who had suppressed viremia (< or = 50 copies/mL) while receiving ART. Successive measurements of T cell immunophenotypes and cellular HIV-1 DNA levels were obtained before and during receipt of ART. On the basis of increases in the CD4+ T cell count, subjects were classified as immunologically concordant (demonstrating an increase of > or = 100 CD4+ T cells/mm3) or discordant (demonstrating an increase of <100 CD4+ T cells/mm3) after 48 weeks of ART. RESULTS: In adjusted analyses, CD4+ and CD8+ T cell activation at baseline was negatively associated with immunologic concordance at week 48 of ART (odds ratio [OR], 0.80 [P = .04] and 0.67 [P = .02], respectively). High memory (CDRA(-)CD62L-) CD8+ T cell counts at baseline (OR, 0.33 [P = .05]) predicted less CD4+ T cell recovery, whereas increased naive CD4+ T cell counts were associated with higher increases in CD4+ T cells (OR, 1.19 [P = .052]). Neither the cell-associated HIV-1 DNA level at baseline (P = .32) nor the cell-associated HIV-1 DNA level at week 48 of ART (P = .42) was associated with immunologic concordance during ART. CONCLUSIONS: These results support the potential clinical usefulness of the baseline determination of immune activation and maturation subsets in the prediction of CD4+ T cell recovery during viral suppression. Furthermore, identification of individuals with reduced potential for CD4+ T cell recovery during ART may provide a rationale for the initiation of early therapy for some patients. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/16741879/Determinants_of_CD4+_T_cell_recovery_during_suppressive_antiretroviral_therapy:_association_of_immune_activation_T_cell_maturation_markers_and_cellular_HIV_1_DNA_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/504718 DB - PRIME DP - Unbound Medicine ER -