Changes in blood CD8+ lymphocyte activation status and plasma HIV RNA levels during antiretroviral therapy.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Changes in blood CD8+ lymphocyte activation status and plasma HIV RNA levels during antiretroviral therapy.

AIDS. 1998 Jul 30;12(11):1267-73. Unique Identifier : AIDSLINE MED/98372110
Bouscarat F; Levacher M; Landman R; Muffat-Joly M; Girard PM; Saimot AG; Brun-Vezinet F; Sinet M; INSERM Unite 13, Hopital Bichat-Claude Bernard, Paris, France.

Abstract: OBJECTIVE: To analyse the relationship between CD8+ lymphocyte phenotype alterations and plasma HIV RNA levels in HIV-infected patients treated with the zidovudine-didanosine combination. METHODS: A total of 30 HIV-infected patients who had never received antiretroviral therapy and who were starting treatment with a combination of zidovudine and didanosine were prospectively studied. Multiparameter flow cytometric analysis of CD8+ lymphocytes and plasma HIV RNA determination were performed on day 0, day 15 and monthly from months 1 to 6. RESULTS: Patients were divided into three categories according to the time-course of plasma HIV RNA levels. In 14 patients, an early and sustained fall in plasma HIV RNA to below the detection limit (500 copies/ml) was observed; in 10 patients, the fall was transient; in six patients, plasma HIV RNA was always detectable (non-responders). The mean CD4+ lymphocyte gain was 120 x 10(6)/l at month 6 in sustained and transient responders, and 55 x 10(6)/l in non-responders. A significant fall in the proportion of CD8+ lymphocytes with an activated phenotype was observed only in the two groups of responders, and was higher in the sustained responders (CD38+HLA-DR+, -56.8%; CD38+CD45RO+, -54.0%; HLA-DR+CD45RO+, -48.4%; CD38+CD28-, -47.3%). CONCLUSION: A fall in the proportion of activated CD8+ lymphocytes is associated with the disappearance of HIV RNA from plasma during antiretroviral therapy. Undetectable plasma HIV RNA is not associated with a return to normal CD8+ lymphocyte activation status after 6 months of treatment, suggesting that viral replication persists in lymphoid tissues.

Keywords: JOURNAL ARTICLE Adult Anti-HIV Agents/*THERAPEUTIC USE CD4 Lymphocyte Count CD8-Positive T-Lymphocytes/CYTOLOGY/*IMMUNOLOGY Didanosine/*THERAPEUTIC USE Drug Therapy, Combination Female Human HIV Infections/*DRUG THERAPY/IMMUNOLOGY/VIROLOGY *HIV-1/GENETICS Immunophenotyping *Lymphocyte Transformation/IMMUNOLOGY Male Middle Age Prospective Studies Reverse Transcriptase Inhibitors/*THERAPEUTIC USE RNA, Viral/BLOOD Support, Non-U.S. Gov't Viral Load Zidovudine/*THERAPEUTIC USE
990130
A9911068

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