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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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Published in: | The Lancet (British edition) 1998-06, Vol.351 (9117), p.1682-1686 |
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creator | Li, TS Tubiana, R Katlama, C Calvez, V Mohand, H Ait Autran, B |
description | 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 |
doi_str_mv | 10.1016/S0140-6736(97)10291-4 |
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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<0·001). Between month 3 and month 12 viral load fell by a median of 1·5 log copies/mL from baseline (4·6 log copies/mL) and CD4-cell count increased by a median of 63/μ/L (from 93/μ/L). Ten patients (six of seven naïve, four of 13 previously treated) were immunological responders. They differed significantly from the ten non-responders in that their viral-load reduction was sustained for 12 months, the increase in CD4 count was greater, and they showed an early increase in memory CD4 T cells with an increase of naïve T cells.
HAART can induce sustained recovery of CD4 T-cell reactivity against opportunistic pathogens in severely immunosuppressed patients. This recovery depends not on baseline values but on the amplitude and duration of viral-load reduction and the increase of memory CD4 T cells.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(97)10291-4</identifier><identifier>PMID: 9734884</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>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</subject><ispartof>The Lancet (British edition), 1998-06, Vol.351 (9117), p.1682-1686</ispartof><rights>1998 Elsevier Ltd</rights><rights>1998 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Jun 6, 1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-84426333cb08ba10e14d56644e237ebdbd8c9d0f27d710df2b470b7c1223dc863</citedby><cites>FETCH-LOGICAL-c468t-84426333cb08ba10e14d56644e237ebdbd8c9d0f27d710df2b470b7c1223dc863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2249754$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9734884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, TS</creatorcontrib><creatorcontrib>Tubiana, R</creatorcontrib><creatorcontrib>Katlama, C</creatorcontrib><creatorcontrib>Calvez, V</creatorcontrib><creatorcontrib>Mohand, H Ait</creatorcontrib><creatorcontrib>Autran, B</creatorcontrib><title>Long-lasting recovery in CD4 T-cell function and viral-load reduction after highly active antiretroviral therapy in advanced HIV-1 disease</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>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<0·001). Between month 3 and month 12 viral load fell by a median of 1·5 log copies/mL from baseline (4·6 log copies/mL) and CD4-cell count increased by a median of 63/μ/L (from 93/μ/L). Ten patients (six of seven naïve, four of 13 previously treated) were immunological responders. They differed significantly from the ten non-responders in that their viral-load reduction was sustained for 12 months, the increase in CD4 count was greater, and they showed an early increase in memory CD4 T cells with an increase of naïve T cells.
HAART can induce sustained recovery of CD4 T-cell reactivity against opportunistic pathogens in severely immunosuppressed patients. This recovery depends not on baseline values but on the amplitude and duration of viral-load reduction and the increase of memory CD4 T cells.</description><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. 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Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, TS</au><au>Tubiana, R</au><au>Katlama, C</au><au>Calvez, V</au><au>Mohand, H Ait</au><au>Autran, B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-lasting recovery in CD4 T-cell function and viral-load reduction after highly active antiretroviral therapy in advanced HIV-1 disease</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1998-06-06</date><risdate>1998</risdate><volume>351</volume><issue>9117</issue><spage>1682</spage><epage>1686</epage><pages>1682-1686</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>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<0·001). Between month 3 and month 12 viral load fell by a median of 1·5 log copies/mL from baseline (4·6 log copies/mL) and CD4-cell count increased by a median of 63/μ/L (from 93/μ/L). Ten patients (six of seven naïve, four of 13 previously treated) were immunological responders. They differed significantly from the ten non-responders in that their viral-load reduction was sustained for 12 months, the increase in CD4 count was greater, and they showed an early increase in memory CD4 T cells with an increase of naïve T cells.
HAART can induce sustained recovery of CD4 T-cell reactivity against opportunistic pathogens in severely immunosuppressed patients. This recovery depends not on baseline values but on the amplitude and duration of viral-load reduction and the increase of memory CD4 T cells.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>9734884</pmid><doi>10.1016/S0140-6736(97)10291-4</doi><tpages>5</tpages></addata></record> |
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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 |
title | Long-lasting recovery in CD4 T-cell function and viral-load reduction after highly active antiretroviral therapy in advanced HIV-1 disease |
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