Immunophenotypic markers and antiretroviral therapy (IMART): T cell activation and maturation help predict treatment response.
To determine whether markers of T cell activation and maturation are independently predictive of the response to potent antiretroviral therapy, the Immunophenotypic Markers and Antiretroviral Therapy study applied a novel data-sharing strategy across 5 Adult AIDS Clinical Trial Group trials that counted naive and activated CD4(+) and CD8(+) T cells in 324 subjects. Regression models--adjustment for baseline CD4 cell count, human immunodeficiency virus (HIV) RNA, and study--revealed that high pretreatment CD8(+) T cell activation predicted virologic failure (P=.046). Additional models showed the greatest increase in CD4(+) T cell counts in subjects with highest pretreatment naive CD4(+) T cell counts (P<.0001), which was enhanced by high CD4(+) and low CD8(+) T cell activation. Total lymphocyte count also predicted a subsequent CD4(+) T cell change. These results document the utility of T cell markers in predicting treatment outcome and their potential value for the study and management of HIV-1 infection.
Mildvan
Donna
D
Beth Israel Medical Center, New York, New York, USA. mildvan@ix.netcom.com
Bosch
Ronald J
RJ
Kim
Ryung S
RS
Spritzler
John
J
Haas
David W
DW
Kuritzkes
Daniel
D
Kagan
Jonathan
J
Nokta
Mostafa
M
DeGruttola
Victor
V
Moreno
Melanie
M
Landay
Alan
A
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D015497:HIV-1 / Q000235:genetics / Q000276:immunology*; D006454:Hemoglobins / Q000276:immunology / Q000378:metabolism; D006801:Humans; D016130:Immunophenotyping; D008213:Lymphocyte Activation / Q000187:drug effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D012044:Regression Analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction
D044966:Anti-Retroviral Agents; D006454:Hemoglobins; D012367:RNA, Viral