Discordant response to antiretroviral therapy: HIV isolation, genotypic mutations, T-cell proliferation and cytokine production

Gabriella D'Ettorre, Gabriele Forcina, Mauro Andreotti, Loredana Sarmati, Lucia Palmisano, Clementina M. Galluzzo, Emanuele Nicastri, Claudio M. Mastroianni, Vincenzo Vullo, Stefano Vella, Massimo Andreoni

Research output: Contribution to journalArticlepeer-review


Objective: To study virologic and immunologic factors associated with discordant treatment response in HIV-infected patients receiving highly active antiretroviral therapy (HAART). Design: Study participants included a total of 27 patients: (a) 10 discordant patients (mean CD4+ cell count, 396.1 × 106 cells/l; mean HIV-RNA, 5.4 log10 copies/ml); (b) seven responder patients (mean CD4+ cell count, 997.5 × 106 cells/l); and (c) 10 failing patients (mean CD4+ cell count 66.5 × 106 cells/l; mean HIV-RNA, 5.4 log10 copies/ml). Methods: The HIV-1 isolation rate and biological phenotype, drug resistance genotypic mutations of HIV-1 strains, recall and HIV-1-specific antigen lymphocyte proliferation (LP), and interleukin (IL)-15 production were studied. Results: Virus isolation was obtained in 30% of discordant patients, and in 100% of failing patients. A higher replication constant was reported in discordant patients. No difference in the number of drug resistance mutations and biological phenotypes of HIV-1 was found in discordant patients with respect to failing patients. Discordant patients developed positive LP responses to Candida albicans and HIV-1 p24. LP in response to C. albicans, HIV-1 p24 and gp160 was positive in responder patients. No significant LP was found in failing patients. Increased levels of IL-15 after stimulation with lipopolysaccaride (LPS) and C. albicans were found in both discordant patients and responder patients. Conversely, a strong reduction of IL-15 levels was observed in failing patients. Conclusion: The present results suggest that decreased virus isolation rate, restoration of both lymphocyte proliferation and IL-15 production are factors involved in the discordant antiretroviral therapy response of HIV-infected patients.

Original languageEnglish
Pages (from-to)1877-1885
Number of pages9
JournalAIDS (London, England)
Issue number14
Publication statusPublished - Sep 27 2002


  • Discordant treatment response
  • Highly active antiretroviral therapy
  • HIV-isolation
  • Interleukin-15
  • Lymphocyte proliferation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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