Neutralizing antibodies against autologous human immunodeficiency virus Type 1 isolates in patients with increasing CD4 cell counts despite incomplete virus suppression during antiretroviral treatment.
Antiretroviral-treated human immunodeficiency virus (HIV) type 1-seropositive individuals can remain clinically stable for a long period of time with an increasing CD4 cell count irrespective of incomplete viral suppression. We evaluated the role of neutralizing antibody (NtAb) activity in the etiopathogenesis of this viro-immunological disconnection (defined as an increasing CD4(+)-cell count despite a persistent, detectable viral load during antiretroviral therapy) in 33 patients failing therapy with two analogue nucleoside reverse transcriptase inhibitors. An HIV NtAb titer of >/=1:25 was detected in specimens from 16 out of 33 (48%) patients. A significant correlation was found between NtAb titers and CD4(+)-cell counts (P = 0.001; r = 0.546) but not with HIV RNA levels in plasma. Five patients with a viro-immunological disconnection had an NtAb titer of >1:125, statistically higher than the NtAb titers for the remaining 28 patients with both virologic and immunologic failure (P < 0.0001). The HIV-specific humoral immune response could play a role during antiretroviral treatment to improve immunological function despite an incomplete suppression of viral load.
Sarmati
L
L
Department of Public Health, University of Rome "Tor Vergata,", Rome, Italy.
d'Ettorre
G
G
Nicastri
E
E
Ercoli
L
L
Uccella
I
I
Massetti
P
P
Parisi
S G
SG
Vullo
V
V
Andreoni
M
M
D000328:Adult; D018791:CD4 Lymphocyte Count; D054407:Chemokine CCL4; D018946:Chemokine CCL5 / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood / Q000276:immunology*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D019402:Macrophage Inflammatory Proteins / Q000097:blood; D008297:Male; D009500:Neutralization Tests; D012367:RNA, Viral / Q000097:blood; D017211:Treatment Failure; D019562:Viral Load
D054407:Chemokine CCL4; D018946:Chemokine CCL5; D015483:HIV Antibodies; D019402:Macrophage Inflammatory Proteins; D012367:RNA, Viral