Prognostic value of proliferative responses to HIV-1 antigen in chronically HIV-infected patients under antiretroviral therapy.
BACKGROUND
In the chronic stage of HIV infection T cell proliferative responses to HIV antigens are rare, mostly of low level, and the influence of responses on antiretroviral therapy is not known.


OBJECTIVE
To determine a potential correlation between HIV-specific proliferative responses and the subsequent course of infection under antiretroviral therapy.


METHODS
Proliferation assays were performed with freshly isolated blood mononuclear cells from 45 chronically HIV-infected HAART treated individuals using HIV-p24, other recall antigens, and mitogens as stimulants. Virus load was monitored at the time of stimulation and during 33 months follow-up.


RESULTS
A proliferative response to HIV antigen stimulation was detectable in 7 of 45 patients (15.5% responders). This group showed elevated reactions against tetanus toxoid and tuberculin, whereas reactions against standard mitogens were equal in the HIV responder and nonresponder groups. None of the seven HIV-specific responders had a blood virus load rebound of more than 1000 genome copies/ml during follow-up, whereas in 50% of the non-responders higher virus rebounds occurred. CD4 cell levels were slightly higher in the responder group, but mostly independent of virus rebound within the non-responders. Only four patients with high and continuous virus rebound experienced a significant CD4 cell decline.


CONCLUSIONS
In patients under HAART, HIV-specific proliferative response is frequently related to anamnestic antigen responses and an enduring control of virus replication.
Mohm
J M
JM
Department of Virology, Institute for Medical Microbiology and Hygiene, University Freiburg, Hermann Herder-Str. 11, D-79104 Freiburg, Germany.
Rump
J-A
JA
Schulte-Mönting
J
J
Schneider
J
J
D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002908:Chronic Disease; D016655:HIV Core Protein p24 / Q000276:immunology* / Q000494:pharmacology; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology*; D011379:Prognosis; D013745:Tetanus Toxoid / Q000494:pharmacology; D014373:Tuberculin / Q000494:pharmacology; D019562:Viral Load; D014766:Viremia
D016655:HIV Core Protein p24; D013745:Tetanus Toxoid; D014373:Tuberculin