Positive effects of combined antiretroviral therapy on CD4+ T cell homeostasis and function in advanced HIV disease.
Highly active antiretroviral therapy (HAART) increases CD4(+) cell numbers, but its ability to correct the human immunodeficiency virus (HIV)-induced immune deficiency remains unknown. A three-phase T cell reconstitution was demonstrated after HAART, with: (i) an early rise of memory CD4(+) cells, (ii) a reduction in T cell activation correlated to the decreasing retroviral activity together with an improved CD4(+) T cell reactivity to recall antigens, and (iii) a late rise of "naïve" CD4(+) lymphocytes while CD8(+) T cells declined, however, without complete normalization of these parameters. Thus, decreasing the HIV load can reverse HIV-driven activation and CD4(+) T cell defects in advanced HIV-infected patients.
Autran
B
B
Laboratoire d'Immunologie Cellulaire, URA CNRS 625, Hôpital Pitié-Salpétriêre, 47-83 Boulevard de l'Hôpital, Paris, France. autran@psl.ap-hop-paris.fr
Carcelain
G
G
Li
T S
TS
Blanc
C
C
Mathez
D
D
Tubiana
R
R
Katlama
C
C
Debré
P
P
Leibowitch
J
J
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000956:Antigens, Viral / Q000276:immunology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006706:Homeostasis; D006801:Humans; D007156:Immunologic Memory; D008213:Lymphocyte Activation; D018655:Lymphocyte Count; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D019438:Ritonavir / Q000627:therapeutic use; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D014373:Tuberculin / Q000276:immunology; D019562:Viral Load; D014766:Viremia; D016047:Zalcitabine / Q000008:administration & dosage / Q000627:therapeutic use; D015215:Zidovudine / Q000008:administration & dosage / Q000627:therapeutic use
D019380:Anti-HIV Agents; D000956:Antigens, Viral; D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D014373:Tuberculin; D015215:Zidovudine; D016047:Zalcitabine; D019438:Ritonavir