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- Title
Evidence of Ongoing Immune Reconstitution in Subjects with Sustained Viral Suppression following 6 Years of Lopinavir-Ritonavir Treatment.
- Authors
Landay, Alan; Da Silva, Barbara A.; King, Martin S.; Albrecht, Mary; Benson, Constance; Eron, Joseph; Glesby, Marshall; Gulick, Roy; Hicks, Charles; Kessler, Harold; Murphy, Robert; Thompson, Melanie; White, Jr., A. Clinton; Wolfe, Peter; McMillan, Florence I.; Hanna, George J.
- Abstract
Background. We evaluated the immunologic impact of highly active antiretroviral therapy in subjects who maintained human immunodeficiency virus type 1 (HIV-1) suppression through 6 years of receiving a lopinavirritonavir-based regimen. Methods. A total of 100 antiretroviral-naive subjects with any CD4+ T cell count initiated therapy with lopinavirritonavir, stavudine, and lamivudine. Sixty-three subjects who remained in the study for 6 years were assessed. Laboratory measurements included plasma HIV-1 RNA levels, multiparameter flow cytometry of immune cells, and markers of maturation and activation. Results. After 6 years, 62 of 63 subjects had plasma HIV-1 RNA levels <50 copies/mL. The mean increase in CD4+ T cell count was 528 cells/μL (P < .001), and 81% of subjects had CD4+ T cell counts >500 cells/μL, compared with 21% of subjects at baseline. The mean ratio of CD4+ T cell count to CD8+ T cell count increased from 0.38 at baseline to 0.96 at year 6 (P < .001). The percentage of subjects with cell counts below the lower limit of normal at year 6, compared with at baseline, was significantly decreased for total T cells, B cells, and natural killer cells. At year 6, the median CD4+ T cell activation level was 3.4%, and the median CD8+ T cell activation level was 5.8%. Conclusions. The receipt of a lopinavir-ritonavir-based regimen resulted in ongoing immune reconstitution through 6 years of therapy in a cohort of HIV-1-infected, antiretroviral-naive subjects with suppressed HIV-1 RNA levels. Normalization of activation marker expression on CD4+ and CD8+ T cell subsets was demonstrated.
- Subjects
ANTIRETROVIRAL agents; LYMPHOCYTES; T cells; ANTIVIRAL agents; KILLER cells; STANDARD deviations
- Publication
Clinical Infectious Diseases, 2007, Vol 44, Issue 5, p749
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1086/511681