title: Immune activation in patients infected with HIV type 1 and maintaining suppression of viral replication by highly active antiretroviral therapy.
abstract: Immune activation associated with HIV infection declines after highly active antiretroviral therapy (HAART), but may persist or recur in some patients. It is not clear whether this reflects a resurgence of HIV replication or another cause of immune activation, such as inflammatory reactions to opportunistic pathogens (immune restoration disease [IRD]). Here, we studied plasma and cellular immune activation markers in adult HIV-1 patients who had received HAART for >12 months and maintained plasma HIV RNA levels of <400 copies/ml for >6 months. Plasma interleukin 1 receptor antagonist and tumor necrosis factor receptor I levels were similar in patients and HIV-negative control subjects, but the highest levels occurred mainly in patients with a history of IRD. In contrast, expression of HLA-DR and CD38 on monocytes and of HLA-DR on CD8(+) T cells was higher in patients than in control subjects. Thus, cellular markers of immune activation are abnormal in some patients with a good virological response to HAART, and abnormalities of plasma immune activation markers correlate with a history of IRD.
authors.affiliation: Department of Clinical Immunology and Biochemical Genetics, Royal Perth Hospital, WA 6001, Australia.
authors.forename: Coral-Ann M
authors.initials: CA
authors.lastname: Almeida
authors.forename: Patricia
authors.initials: P
authors.lastname: Price
authors.forename: Martyn A H
authors.initials: MA
authors.lastname: French
mesh_terms: D036541:ADP-ribosyl Cyclase / Q000378:metabolism; D051997:ADP-ribosyl Cyclase 1; D017088:AIDS-Related Opportunistic Infections / Q000276:immunology*; D015703:Antigens, CD / Q000097:blood / Q000378:metabolism; D023241:Antiretroviral Therapy, Highly Active; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D015497:HIV-1 / Q000187:drug effects / Q000276:immunology* / Q000502:physiology; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007107:Immune System / Q000187:drug effects*; D008562:Membrane Glycoproteins; D017472:Receptors, Interleukin-1 / Q000037:antagonists & inhibitors; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I; D014779:Virus Replication / Q000187:drug effects
chemical_list: D015703:Antigens, CD; D006684:HLA-DR Antigens; D008562:Membrane Glycoproteins; D017472:Receptors, Interleukin-1; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D036541:ADP-ribosyl Cyclase; C498154:CD38 protein, human; D051997:ADP-ribosyl Cyclase 1