engleski

Utjecaj HAART-a na fenotip T-stanica u HIV bolesnika liječenih u Zagrebu, Hrvatska

Objective: Our goal was to describe the influence of highly active antiretroviral therapy (HAART) consisting of zidovudine, lamivudine and indinavir on the phenotype of T-cells in advanced HIV-disease. Methods: The prospective, 1 year study enrolled 27 treatment-naive symptomatic HIV-1-infected adults with high pre-treatment viremia (median 4.6 log of HIV-1 RNA copies/ml) and low numbers of CD4+ T-cells (median 88 cells/μ l). Lymphocyte subpopulations were analyzed by flow cytometry (Beckman Coulter) abd viremia was determined by ultrasensitive RT-PCR (Amplicor, Roche) before and after 1, 3, 6 and 12 months of treatment. Anti-CD38 antibody binding sites on bright CD8+ T cells were quantified by CELLQUANT (Biocytex). Results: HAART efficiently reduced plasma viremia to undetectable levels (median 1.69 log of HIV-1 RNA copies/ml after 12 months) in 24 patients and increased counts of CD4+ T cells (absolute count of 225 cells/ μ l after 12 months). Percentages of memory CD45RO+CD4+T-lymphocytes significantly increased after the first month of treatment (pretreatment median 6.6%, 1 month median 14.5%). Significant increases in truly naIve CD62L+CD45RA+CD4+T-lymphocytes were observed after 12 months of treatment (pretretment median 19.1% of CD4+T-cells, 12 months median 25.1%). Therapy induced decrease in viral load was parallel to the significant decrease in the percentages of CD38+CD8+T-lymphocytes (pre-treatment median 45.3%, 12 months median 17.7%). HIV-patients with at least 9 months of undetectable plasma viremia still expressed increased numbers of anti-CD38 antibody binding ites on bright CD8+ Tcells compared with healthy controls (median 5219 in HIV-patients, 908 for controls) suggesting ongoing immune stimulation. HAART enabled increase in the percentages of CD4+ an CD8+ T-cells expressing CD28 (12 months median values 76.8% of CD4+ T-cells, 50.3% of CD8+T-cells). Conclusion: Selected lymphocyte subpopulation did not return to referral values. One year of HAART allows at least partial correction of HIV-induced changes in the phenotype of T-lymphoctes in advanced stages of HIV disease. Persistent expression of CD38 on CD8+ T-cells despite 9 months of HAART-induced undetectable viremia without clinically apparent opportunistic diseases, suggests residual viral activity.

HAART; T-cells; phenotype; HIV

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