Expansion of pre-terminally differentiated CD8 T cells in chronic HIV-positive patients presenting a rapid viral rebound during structured treatment interruption

Gianpiero D'Offizi, Carla Montesano, Chiara Agrati, Cristiana Gioia, Massimo Amicosante, Simone Topino, Pasquale Narciso, Leopoldo Paolo Pucillo, Giuseppe Ippolito, Fabrizio Poccia

Research output: Contribution to journalArticle

Abstract

Objective: The influence of structured treatment interruption on effector/memory CD8 T cell dynamics was analysed in chronic HIV-infected patients showing a rapid or delayed viral rebound. Design: Structured treatment interruption consisted of at least one month of discontinuation, followed by highly active antiretroviral therapy (HAART) resumption. Two groups of HIV structured treatment interruption patients were selected on the basis of plasma viral HIV-RNA value (> 30 000 copies/ml, branched DNA): group A (n = 14), patients with a rapid viral rebound (within one month) and group B (n = 6), patients with a delayed or no viral rebound (after a minimum of 4 months). Methods: A clinical and immunological follow-up was performed at HAART suspension (t 0), one month from suspension (t 1), at HAART resumption (t 2), and 30 days from resumption (t 3). Results: A sustained viral rebound was observed in group A patients, showing a rapid expansion of circulating CD8 T lymphocytes. In this group, the frequencies of CD8 T cells releasing IFN-γ after mitogen-induced or Gag-specific stimulation were highly increased after HAART discontinuation. Nevertheless, these CD8 T lymphocytes were mainly composed of pre-terminally differentiated cytotoxic T lymphocytes (CTL) expressing a CCR7- CD27+/- CD45RA- phenotype and a reduced amount of perforin. In contrast, group B patients showed no significant changes in immunological parameters during a prolonged drug-free period. Conclusion: These data indicate that monitoring CD8 T cell dynamics during structured treatment interruption could be clinically relevant, and new therapeutic strategies should aim qualitatively to restore CTL effector functions.

Original languageEnglish
Pages (from-to)2431-2438
Number of pages8
JournalAIDS (London, England)
Volume16
Issue number18
DOIs
Publication statusPublished - Dec 6 2002

Keywords

  • CCR7
  • CD27
  • CTL
  • HAART
  • HIV-1 Gag
  • Peptides

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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