T Cell Activation Is Associated with Lower CD4+ T Cell Gains in Human Immunodeficiency Virus-Infected Patients with Sustained Viral Suppression during Antiretroviral Therapy

• Published in: The Journal of infectious diseases 2003-05, Vol.187 (10), p.1534-1543
• Main Authors: Hunt, Peter W, Martin, Jeffrey N, Sinclair, Elizabeth, Bredt, Barry, Hagos, Elilta, Lampiris, Harry, Deeks, Steven G
• Format: Article
• Language: English
• Subjects: Adult; AIDS; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Biological and medical sciences; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - drug effects; CD4-Positive T-Lymphocytes - immunology; Female; Highly active antiretroviral therapy; HIV; HIV 1; HIV infections; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV-1 - drug effects; HIV-1 - genetics; HIV-1 - physiology; HIV/AIDS; Human viral diseases; Humans; Infections; Infectious diseases; Lymphocyte Activation; Male; Medical sciences; Middle Aged; RNA; RNA, Viral - blood; T lymphocytes; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viremia; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/374786

Although T cell activation is associated with disease progression in untreated human immunodeficiency virus type 1 (HIV-1) infection, its significance in antiretroviral-treated patients is unknown. Activated (CD38+HLA-DR+) T cell counts were measured in 99 HIV-infected adults who had maintained a plasma HIV RNA level ⩽1000 copies/mL for a median of 21 months while receiving antiretroviral therapy. Patients with sustained viral suppression had lower levels of T cell activation than untreated patients but higher levels than HIV-uninfected control subjects. Persistent T cell activation was associated with decreased CD4+ T cell gains during therapy. For every 5% increase in the proportion of activated CD8+ T cells, 35 fewer CD4+ T cells/mm3 were gained. Increased T cell activation was associated with shorter duration of viral suppression, hepatitis C virus coinfection, frequent low-level viremia, and lower nadir CD4+ T cell counts. Interventions that directly target T cell activation or the determinants of activation may prove to be useful adjuvants to antiretroviral therapy