title: Improvement in cell-mediated immune function during potent anti-human immunodeficiency virus therapy with ritonavir plus saquinavir.
abstract: Inhibiting human immunodeficiency virus (HIV) replication with potent antiretroviral therapy may result in improved immune function, and this may lead to favorable outcomes, independent of changes in CD4+ lymphocyte count. The effect of combination protease inhibitor therapy (ritonavir plus saquinavir) on functional measures of cell-mediated immunity in 41 HIV-infected patients from one center of a multicenter trial was investigated. After 24 weeks, median plasma virus load decreased from 4.74 log10 copies/mL to below the detection limit of the assay (2.30 log10), and mean CD4+ lymphocyte count increased from 284 cells/microL to 413 cells/microL. Proliferative responses to phytohemagglutinin developed in 21 of 34 patients in whom responses were absent at baseline. Increases were observed in interleukin-2, -12, and -10 production and in the expression of CD28 on CD8+ lymphocytes. Initiation of potent anti-HIV therapy results in a degree of immune restoration, suggesting that HIV-induced immune suppression is a dynamic and potentially reversible process.
authors.affiliation: Department of Medicine, University of Ottawa, Canada. jangel@ogh.on.ca
authors.forename: J B
authors.initials: JB
authors.lastname: Angel
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.forename: K
authors.initials: K
authors.lastname: Parato
authors.forename: L G
authors.initials: LG
authors.lastname: Filion
authors.forename: F
authors.initials: F
authors.lastname: Diaz-Mitoma
authors.forename: P
authors.initials: P
authors.lastname: Daftarian
authors.forename: B
authors.initials: B
authors.lastname: Pham
authors.forename: E
authors.initials: E
authors.lastname: Sun
authors.forename: J M
authors.initials: JM
authors.lastname: Leonard
authors.forename: D W
authors.initials: DW
authors.lastname: Cameron
mesh_terms: D018106:CD28 Antigens / Q000276:immunology / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002455:Cell Division; D004359:Drug Therapy, Combination; D005434:Flow Cytometry; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007111:Immunity, Cellular; D016753:Interleukin-10 / Q000378:metabolism; D018664:Interleukin-12 / Q000378:metabolism; D007376:Interleukin-2 / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000276:immunology; D010835:Phytohemagglutinins / Q000276:immunology; D012367:RNA, Viral / Q000302:isolation & purification; D019438:Ritonavir / Q000008:administration & dosage / Q000627:therapeutic use*; D019258:Saquinavir / Q000008:administration & dosage / Q000627:therapeutic use*; D019562:Viral Load
chemical_list: D018106:CD28 Antigens; D017320:HIV Protease Inhibitors; D007376:Interleukin-2; D010835:Phytohemagglutinins; D012367:RNA, Viral; D016753:Interleukin-10; D018664:Interleukin-12; D019258:Saquinavir; D019438:Ritonavir