title: Changes in immunological and virological parameters in HIV-1 infected subjects following leukapheresis.
abstract: In order to assess immune responses during HIV-1 therapeutic immunization, a large number of blood mononuclear cells (PBMC) are needed. Clinical tolerance and safety, as well as changes in immunological and virological parameters, were assessed, following leukapheresis in HIV-1 infected subjects with CD4(+) cell count >200 x 10(6)/l. PBMC were collected using a Fenwal CS3000 cell separator in 29 subjects with mean CD4(+) cell counts of 503 x 10(6)/l (range 172-1,119) and viral load of 2.5 log(10) copies/ml (range <1.7-5.4). Twenty-four (83%) subjects were on antiretroviral therapy while 5 (17%) were untreated. The blood volume processed was 7 L over a period of 3 hours. A mean value (+/- standard error) of 82 +/- 26 x 10(9)/l lymphocytes was collected by a single apheresis in a mean volume of 200 +/- 1.8 ml, containing 9.0 +/- 1.3 x 10(9)/l CD4(+) and 10.2 +/- 1.3 x 10(9)/l CD8(+) cells. The leukapheresis procedures were well tolerated and no immediate or delayed side effects were observed within 90 days of follow-up. No changes from blood pre-leukapheresis values were detected for white blood cells, lymphocytes, monocytes, CD8(+), CD34(+), naive and memory CD4(+) cell counts immediately after, 1 h, 7 days, or within 90 days after leukapheresis. However, absolute CD4(+) cell counts and percentage significantly increased from pre-leukapheresis values after 1 h (530 +/- 43 vs. 700 +/- 75 cell x 10(6)/l; 32.6 +/- 1.6 vs. 36.9 +/- 1.9%; P < 0.001 for both paired t-tests) before returning to pre-leukapheresis levels on day 7. No significant changes in viral load from pre-leukapheresis levels in treated or untreated subjects were detected at any time points. We conclude that leukapheresis in HIV-1 infected subjects with CD4(+) cell counts >200 x 10(6)/l is safe and induces a transient increase in the absolute and percentage of CD4(+) cell count without enhancing viral replication.
authors.affiliation: Immunodeficiency Service, Royal Victoria Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
authors.forename: M R
authors.initials: MR
authors.lastname: Boulassel
authors.forename: G
authors.initials: G
authors.lastname: Spurll
authors.forename: D
authors.initials: D
authors.lastname: Rouleau
authors.forename: C
authors.initials: C
authors.lastname: Tremblay
authors.forename: M
authors.initials: M
authors.lastname: Edwardes
authors.forename: R P
authors.initials: RP
authors.lastname: Sekaly
authors.forename: R
authors.initials: R
authors.lastname: Lalonde
authors.forename: J-P
authors.initials: JP
authors.lastname: Routy
mesh_terms: D000328:Adult; D001800:Blood Specimen Collection / Q000379:methods; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000628:therapy / Q000821:virology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D007937:Leukapheresis / Q000592:standards*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012367:RNA, Viral / Q000097:blood
chemical_list: D012367:RNA, Viral