Immunophenotype of HIV+ patients during CD4 cell-monitored treatment interruption: Role of the IL-7/IL-7 receptor system

Elisa Nemes, Enrico Lugli, Milena Nasi, Roberta Ferraresi, Marcello Pinti, Roberto Bugarini, Vanni Borghi, Francesca Prati, Roberto Esposito, Andrea Cossarizza, Cristina Mussini

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To investigate immunological changes during CD4-guided therapy interruption in HIV+ patients who suspended HAART. PATIENTS: Seventeen patients aged > 18 years, who had received HAART for at least 12 months, and had a pre-interruption CD4+ cell count > 500 cells/μl, interrupted treatment. Median nadir CD4+ cell count was 288 cells/μl. HIV plasma viral load at discontinuation was <50 or > 50 copies/ml. Criteria for restarting treatment were: a CD4+ T-lymphocyte count <350 cells/μl on two separate occasions, a clinical manifestation of AIDS, and the patient's desire to resume HAART. Eleven patients were still off therapy after 12 months (group A); according to the first criterion, six patients restarted therapy within 12 months (group B). METHODS: Haematological, viro-immunological, cytofluorimetic and molecular assays were performed at baseline and every 2 months following standard methods. Statistical analysis was performed under Stata 7.0. RESULTS: In the first 2 months of treatment interruption, a significant increase in viral load and CD8+ lymphocyte activation occurred. Then such parameters decreased and remained stable. In all patients, a decrease in CD4+ lymphocytes took place as well, that affected in a similar manner naive, central memory, effector memory and terminally differentiated cells. Group B always presented lower amounts of CD4+ effector memory lymphocytes. The expression of CD127 was always higher in group A. CONCLUSIONS: The loss of CD4+ lymphocytes upon viral rebound is equal among naive and memory subsets. Patients with higher expression of CD127, who are likely to exert a better capacity to utilize endogenous interleukin-7 by T cells, could remain off therapy for longer periods.

Original languageEnglish
Pages (from-to)2021-2032
Number of pages12
JournalAIDS (London, England)
Volume20
Issue number16
DOIs
Publication statusPublished - Oct 2006

Keywords

  • HAART
  • IL-7 receptor system
  • Lymphocyte activation
  • Therapy interruption
  • Viral load

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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