engleski

Immunologic reconstruction during 1 year of HAART in patients treated in Zagreb, Croatia

Aim: Our goal was to assess the effect of HAART on cellular immunity in advanced HIV-disease. Study design: prospective longitudinal study Methods: Immune reconstitution was estimated by monitoring cell surface markers representing na&iuml ; ; ve and memory CD4+ T-lymphocytes as well as activated CD38+CD8+ T-lymphocytes (Coulter Epics XL flow cytometer). The expression of costimulatory molecule CD28 on CD4+ and CD8+ T-lymphocytes was used to determine the ability of cells to adequately respond to antigens. The selected immune parameters were analysed at baseline and after 1, 3, 6 and 12 months of HAART in 25 treatment-naive symptomatic HIV-1-infected adults with high pre-treatment viremia (median 4.6 log of HIV-1 RNA copies/ml) and low number of CD4+ T-lymphocytes (median 88 cells/ l). The HAART regimen included a combination of zidovudine, lamivudine and indinavir at standard doses for 1 year. Viral load was determined by RT-PCR (Amplicor HIV-1 Monitor, Roche). Controls consisted of 30 apparently healthy HIV-1 negative persons. Results: HAART effectively reduced plasma viremia to undetectable levels (median 1.69 log of HIV-1 RNA copies/ml after 12 months). Incomplete suppression of viremia was detected in only two patients. HAART-induced decrease in plasma viremia coincided with a significant increase in the percentage and number of CD4+ T-lymphocytes (median 13, 8% and absolute count of 225 cells/ l). Decreased percentages of activated CD38+CD8+ T-lymphocytes were also observed. Inspite of the significant increase in the memory CD4+ T-lymphocytes, only slight change in the na&iuml ; ; ve subpopulation of these cells was observed (3.65 versus 3.8% median pre-treatment and 12 month values, respectively). HAART enabled the increase in the expression of costimulatory molecule CD28 on both CD4+ and CD8+ T-lymphocytes. Selected immune parameters did not return to referral values after one year treatment. Conclusion: We conclude that HAART allows at least partial immune reconstitution within the period of 1 year, even in advanced stages of HIV-disease.

HAART; Croatia

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