Cytokines and β-chemokines play an important role in the complex interaction between HIV-1 and the immune system. We studied platelet-free plasma (PFP) levels and ex vivo production of cytokines and β-chemokines at different HIV disease stages and the influence of potent protease inhibitor therapy on their production in late-stage patients. Mitogen-induced production of MIP-1α, MIP-1β, and RANTES by PBMCs was higher in HIV- infected patients than in HIV-seronegative controls. Patients with late-stage HIV infection (CD4+ cells + cells >150/μl). Pretreatment RANTES production correlated negatively with CD4+ and CD8+ cell counts; also, MIP-1α production was inversely correlated with CD4+ cell counts. Among patients with a CD4+ cell count + cell counts after protease inhibitor therapy. The production of MIP-1α, MIP-1β, RANTES, and IFN-γ was markedly reduced at 8 weeks and partially restored at 24 weeks after beginning protease inhibitor therapy. PFP levels of RANTES showed a concurrent decrease. Patients with more advanced HIV infection show a higher production of inflammatory cytokines, which is reduced by protease inhibitor therapy. Residual late-stage IL-2 producers may represent a subset of patients with a higher potential for immunologic reconstitution.
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