AIDSWEEKLY Plus; Monday, December 1, 2003
Staff Medical Writers

"In most HIV-1-infected patients, highly active antiretroviral therapy (HAART) reduces plasma viral load to <50 copies/mL and increases CD4+ T-cell number and function," researchers in Italy explained. "However, it is still unclear whether alterations of T-cell receptor (TCR) beta-chain variable region (BV) repertoire, tightly related to disease progression, call be fully recovered by long-term treatment with HAART."

To clarify the long-term effects of HAART, A. Giovannetti and colleagues at the University of Rome 'La Sapienza' "analyzed the evolution of both T-cell subset composition and TCRBV perturbations in chronically HIV-1-infected patients with moderate immunodeficiency" during 36 months of treatment.

"Despite persistently suppressed HIV replication, the rate of CD4+ T-cell repopulation, after an initial burst, progressively declined throughout the study period, resulting in a mean CD4+ T-cell count at the end of follow-up that was still significantly lower in HIV patients than in HIV-seronegative controls," study data showed. "This was seen in association with all incomplete restitution of both CD4 and CD8 TCRBV repertoire disruptions and was also demonstrated by the appearance of new TCRBV oligoclonal expansions occurring during HAART."

These findings demonstrate that "three years of fully suppressive HAART may be not adequate to normalize CD4 counts and TCRBV repertoires in patients starting HAART with moderately advanced disease," the investigators concluded.

Giovannetti and coauthors published their study in the Journal of Acquired Immune Deficiency Syndromes (Persistently biased T-cell receptor repertoires in HIV-1-infected combination antiretroviral therapy-treated patients despite sustained suppression of viral replication. J Acquir Immune Defic Syndr. 2003 Oct 1;34(2):140-54.

For additional information, contact A. Giovannetti, University of Rome 'La Sapienza', Department of Clinical Medicine, Division of Clinical Immunology and Allergy, Viale University 37, I-00185 Rome, Italy.

The publisher of the Jaids - Journal of Acquired Immune Deficiency Syndromes can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

The information in this article comes under the major subject areas of AIDS & HIV and Immunology.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Giovannetti A, Pierdominici M, Marziali M, et al., "Persistently biased T-cell receptor repertoires in HIV-1-infected combination antiretroviral therapy-treated patients despite sustained suppression of viral replication", J Acquir Immune Defic Syndr. 2003 Oct 1;34(2):140-54.

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