Long-lasting recovery in CD4 T-cell function and viral-load reduction after highly active antiretroviral therapy in advanced HIV-1 disease

Highly active antiretroviral therapy (HAART) decreases viral load and increases CD4 T-cell counts in patients with advanced HIV-1 infection. Whether HAART can improve CD4 T-cell function, and the biological characteristics affecting immune reconstitution, remain unclear. We undertook an open prospec...

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Bibliographic Details
Published in:The Lancet (British edition) 1998-06, Vol.351 (9117), p.1682-1686
Main Authors: Li, TS, Tubiana, R, Katlama, C, Calvez, V, Mohand, H Ait, Autran, B
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Anti-HIV Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antibodies, Monoclonal
Antiretroviral agents
Antiviral agents
Biological and medical sciences
CD4-Positive T-Lymphocytes - physiology
Cell Division
Cells
Drug therapy
Female
HIV
HIV Infections - drug therapy
HIV Infections - immunology
HIV-1 - genetics
Human immunodeficiency virus
Humans
Immunocompetence
Indinavir - therapeutic use
Male
Medical sciences
Microorganisms
Middle Aged
Pharmacology. Drug treatments
Pilot Projects
Prospective Studies
Protease Inhibitors - therapeutic use
Proteinase inhibitors
Reverse Transcriptase Inhibitors - therapeutic use
Ritonavir - therapeutic use
RNA, Viral - analysis
Time Factors
Viral Load
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Summary:Highly active antiretroviral therapy (HAART) decreases viral load and increases CD4 T-cell counts in patients with advanced HIV-1 infection. Whether HAART can improve CD4 T-cell function, and the biological characteristics affecting immune reconstitution, remain unclear. We undertook an open prospective pilot study to address these issues. Both treatment-naïve and previously treated patients were included. 20 patients (seven naïve, 13 previously treated) were treated with one protease inhibitor and two reverse-transcriptase inhibitors and followed up for 12 months. We measured CD4-cell proliferation in response to cytomegalovirus and tuberculin antigens and counted subsets of CD4 cells at baseline and months 1, 3, 6, 9, and 12. Patients who had no antigen-specific reactivity at baseline but developed it while receiving HAART were classified as immunological responders. Four patients had antigen-specific reactivity at baseline compared with 14 at month 12 (p
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(97)10291-4