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- Title
Association between discordant immunological response to highly active anti-retroviral therapy, regulatory T cell percentage, immune cell activation and very low-level viraemia in HIV-infected patients.
- Authors
Saison, J.; Ferry, T.; Demaret, J.; Maucort Boulch, D; Venet, F.; Perpoint, T.; Ader, F.; Icard, V.; Chidiac, C.; Monneret, G.
- Abstract
The mechanisms sustaining the absence of complete immune recovery in HIV-infected patients upon long-term effective highly active anti-retroviral therapy (HAART) remain elusive. Immune activation, regulatory T cells ( Tregs) or very low-level viraemia ( VLLV) have been alternatively suspected, but rarely investigated simultaneously. We performed a cross-sectional study in HIV-infected aviraemic subjects (mean duration of HAART: 12 years) to concomitantly assess parameters associated independently with inadequate immunological response. Patients were classified as complete immunological responders ( cIR, n = 48) and inadequate immunological responders ( iIR, n = 39), depending on the CD4+ T cell count (> or < 500/mm3). Clinical and virological data (including very low-level viraemia) were collected. In parallel, immunophenotyping of CD4+ lymphocytes, including Treg subsets, and CD8+ T cells was performed. Percentages of activated CD4+ T cells, Tregs, effector Tregs and terminal effector Tregs were found to be significantly elevated in iIR. Neither the percentage of activated CD8+ T cells nor VLLV were found to be associated with iIR. In the multivariate analysis, nadir of CD4+ T cell count and percentage of Tregs were the only two parameters associated independently with iIR [odds ratio ( OR) = 2·339, P = 0·001, and OR = 0·803, P = 0·041]. We present here the largest study investigating simultaneously the immune response to long-term HAART, activation of CD4+ and CD8+ T cells, Treg percentages and very low-level viraemia. Causative interactions between Tregs and CD4+ T cells should now be explored prospectively in a large patients cohort.
- Subjects
HIGHLY active antiretroviral therapy; T cells; VIREMIA; HIV-positive persons; IMMUNOREGULATION; CROSS-sectional method; IMMUNOPHENOTYPING
- Publication
Clinical & Experimental Immunology, 2014, Vol 176, Issue 3, p401
- ISSN
0009-9104
- Publication type
Article
- DOI
10.1111/cei.12278