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- Title
Dynamics of Immune Reconstitution and Activation Markers in HIV+ Treatment-Naïve Patients Treated with Raltegravir, Tenofovir Disoproxil Fumarate and Emtricitabine.
- Authors
Funderburg, Nicholas T.; Andrade, Adriana; Chan, Ellen S.; Rosenkranz, Susan L.; Lu, Darlene; Clagett, Brian; Pilch-Cooper, Heather A.; Rodriguez, Benigno; Feinberg, Judith; Daar, Eric; Mellors, John; Kuritzkes, Daniel; Jacobson, Jeffrey M.; Lederman, Michael M.
- Abstract
Background:The dynamics of CD4+ T cell reconstitution and changes in immune activation and inflammation in HIV-1 disease following initiation of antiretroviral therapy (ART) are incompletely defined and their underlying mechanisms poorly understood. Methods:Thirty-nine treatment-naïve patients were treated with raltegravir, tenofovir DF and emtricitabine. Immunologic and inflammatory indices were examined in persons with sustained virologic control during 48 weeks of therapy. Results:Initiation of ART increased CD4+ T cell numbers and decreased activation and cell cycle entry among CD4+ and CD8+ T cell subsets, and attenuated markers of coagulation (D-dimer levels) and inflammation (IL-6 and TNFr1). These indices decayed at different rates and almost all remained elevated above levels measured in HIV-seronegatives through 48 weeks of viral control. Greater first and second phase CD4+ T cell restoration was related to lower T cell activation and cell cycling at baseline, to their decay with treatment, and to baseline levels of selected inflammatory indices, but less so to their changes on therapy. Conclusions:ART initiation results in dynamic changes in viral replication, T cell restoration, and indices of immune activation, inflammation, and coagulation. These findings suggest that determinants of T cell activation/cycling and inflammation/coagulation may have distinguishable impact on immune homeostasis. Trial Registration:Clinicaltrials.gov NCT00660972
- Subjects
IMMUNE reconstitution inflammatory syndrome; BIOMARKERS; HIV-positive persons; RALTEGRAVIR; TENOFOVIR; EMTRICITABINE; CD4 antigen; T cells; ANTIRETROVIRAL agents; THERAPEUTICS
- Publication
PLoS ONE, 2013, Vol 8, Issue 12, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0083514