RANTES production by T cells and CD8-mediated inhibition of human immunodeficiency virus gene expression before initiation of potent antiretroviral therapy predict sustained suppression of viral replication.
A prospective blinded study was conducted to determine whether immunological differences exist between patients receiving potent antiretroviral therapy who are able to achieve and maintain an undetectable virus load (<50 copies/mL) and those who are not. Eleven patients receiving protease inhibitor-containing antiretroviral therapy were studied for 1 year. After analysis of all baseline samples, patient virus load was disclosed, and patients were classified as suppressors (those who maintained undetectable virus load for 1 year) and nonsuppressors. Baseline virus load and CD4+ T cell count did not differ significantly between the 2 groups. Levels of RANTES production by CD4+ and CD8+ T cells and CD8-mediated inhibition of human immunodeficiency virus type 1 gene expression before initiation of antiretroviral therapy were significantly associated with an undetectable virus load maintained for 1 year (P<.05). Thus, a functionally intact T cell-mediated immune system at the time of initiation of potent antiretroviral therapy may predict long-term virus suppression.
Fransen
S
S
Department of Pathology, McMaster University Health Sciences Centre, Hamilton, Ontario, Canada.
Copeland
K F
KF
Smieja
M
M
Smaill
F
F
Rosenthal
K L
KL
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D018946:Chemokine CCL5 / Q000096:biosynthesis*; D015870:Gene Expression; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D016325:HIV Long Terminal Repeat; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics / Q000378:metabolism / Q000502:physiology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D019258:Saquinavir / Q000627:therapeutic use; D016037:Single-Blind Method; D013601:T-Lymphocytes / Q000276:immunology*; D019562:Viral Load; D014779:Virus Replication; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D018946:Chemokine CCL5; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D015215:Zidovudine; D019258:Saquinavir