Changes in CD4+ T-cell differentiation phenotype during structured treatment interruption in patients with chronic HIV-1 infection.
Markers of maturation and activation were measured on peripheral CD4+ T cells in chronically HIV-1-infected patients in a randomized, controlled pilot study of structured treatment interruption (STI). Eight subjects underwent 2 cycles of 1 month off and 1 month on highly active antiretroviral therapy (HAART), followed by a final 3-month interruption. During STI, CD4+ T-cell percentage remained relatively stable in 4 of 8 subjects. The remaining 4 STI subjects had significant rapid decline in CD4+ T-cell percentage during STI, followed by return to pre-STI baseline while on HAART. Changes in overall CD4+ T-cell percentage corresponded with fluctuations in the CD45RA+CCR7+ naive and CD45RA-CCR7+ central memory subsets. Subjects with variable CD4+ T-cell percentages tended to have higher pre-HAART plasma HIV-1 RNA set-points and experienced higher levels of plasma HIV-1 RNA rebound during STI. These results suggest that interruptions should be avoided whenever possible in patients on HAART with high plasma HIV-1 RNA set-points.
Alexander
Thomas H
TH
Duke University Medical Center, Durham, NC 27705, USA.
Ortiz
Gabriel M
GM
Wellons
Melissa F
MF
Allen
Andrew
A
Grace
Edward J
EJ
Schweighardt
Becky
B
Brancato
Jason
J
Sandberg
Johan K
JK
Furlan
Scott N
SN
Miralles
G Diego
GD
Nixon
Douglas F
DF
Bartlett
John A
JA
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D002454:Cell Differentiation / Q000276:immunology; D004334:Drug Administration Schedule; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D016130:Immunophenotyping; D008213:Lymphocyte Activation / Q000276:immunology; D012367:RNA, Viral / Q000097:blood; D012016:Reference Values; D019562:Viral Load
D012367:RNA, Viral