Prolonged suppression of human immunodeficiency virus type 1 (HIV-1) viremia in persons with advanced disease results in enhancement of CD4 T cell reactivity to microbial antigens but not to HIV-1 antigens.
CD4 T cell responses were studied for >2 years in 27 zidovudine-experienced patients with advanced human immunodeficiency virus type 1 (HIV-1) infection who received triple combination drug therapy with indinavir, zidovudine and lamivudine or zidovudine plus lamivudine or zidovudine alone for 24-42 weeks before switching to the three-drug therapy. Subjects initially given the three drugs had viremia suppressed to undetectable levels and increases in T cell proliferative and cytokine responses to microbial antigens through 2 years of follow-up. Patients receiving the triple-drug therapy after either indinavir or zidovudine-lamivudine treatment had similar increases in T cell responses only if they also had suppression of virus load. CD4 T cell reactivity to HIV-1 antigens was not restored. Prolonged indinavir-zidovudine-lamivudine treatment has significant but incomplete enhancing effects on CD4 T cell reactivity, which could be important in host control of microbial and persistent HIV-1 infections.
Rinaldo
C R
CR
Deptartment of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261, USA. rinaldo+@pitt.edu
Liebmann
J M
JM
Huang
X L
XL
Fan
Z
Z
Al-Shboul
Q
Q
McMahon
D K
DK
Day
R D
RD
Riddler
S A
SA
Mellors
J W
JW
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D002455:Cell Division / Q000187:drug effects; D018925:Chemokines / Q000096:biosynthesis; D016207:Cytokines / Q000096:biosynthesis; D004311:Double-Blind Method; D005260:Female; D015488:HIV Antigens / Q000276:immunology*; D015497:HIV-1 / Q000187:drug effects / Q000276:immunology; D006801:Humans; D019469:Indinavir / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008934:Mitogens / Q000276:immunology; D012367:RNA, Viral / Q000378:metabolism; D014766:Viremia / Q000188:drug therapy / Q000276:immunology*; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D000942:Antigens, Bacterial; D018925:Chemokines; D016207:Cytokines; D015488:HIV Antigens; D008934:Mitogens; D012367:RNA, Viral; D019259:Lamivudine; D015215:Zidovudine; D019469:Indinavir