Immunity in HIV-1-infected adults with a previous state of moderate-severe immune-suppression and more than 500 CD4+ T cell after highly active antiretroviral therapy.
We evaluated phenotypic and functional parameters of immune restoration of 27 HIV-infected patients on highly active antiretroviral therapy (HAART) (HIV-cases) with HIV-RNA levels below detectable limits at least during 18 months, and CD4+ cell per microliter higher than 500 at the moment of the study and lower than 300 anytime before. These patients were compared with 11 HIV-controls that never had less than 500 CD4+ cell per microliter and 20 healthy-controls (HIV seronegative subjects) in a cross-sectional study. HIV-cases had lower counts of naïve CD4+ than HIV-controls and healthy-controls. HIV-patients (both HIV-cases and HIV-controls) showed higher values of naïve and memory CD8+ counts than healthy-controls. TREC-bearing cell levels were significantly lower in HIV-cases than in healthy-controls. Peripheral blood mononuclear cells (PBMC) cultures, HIV-cases had lower values in proliferation to streptokinase (SK) and tetanus toxin (TT) than in healthy-controls. HIV-cases had lower IFN-gamma and higher IL-5 production with pokeweed than healthy-controls ( P < 0.01). However, IL-5 production of HIV-cases after TT stimulation was lower than in HIV-controls and healthy-controls. Total IgG and IgG1 levels were significantly higher in HIV-cases than in HIV-controls and healthy-controls. Also, IgM levels were significantly higher in HIV-cases than in healthy-controls. Nevertheless, IgG2 levels were significantly lower in HIV-cases and HIV-controls than in healthy-controls. The levels of specific Igs antipneumococcal capsular polysaccharide and TT were significantly lower in HIV-cases than in healthy-controls. HIV-patients with a previous state of severe-moderate immunosuppression normalizing their CD4+ counts have a incomplete immune reconstitution after HAART. Long-term consequences of this subclinical immune deficiency remain to be determined.
Resino
Salvador
S
Laboratorio de Immuno-Biología Molecular, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo 46, 28007 Madrid, Spain.
Rivero
Laura
L
Ruiz-Mateos
Ezequiel
E
Galán
Isabel
I
Franco
Jaime Munoz
JM
Munoz-Fernández
Maria Angeles
MA
Leal
Manuel
M
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D049109:Cell Proliferation; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007109:Immunity; D007074:Immunoglobulin G / Q000145:classification; D007165:Immunosuppression Therapy; D007371:Interferon-gamma / Q000097:blood; D015848:Interleukin-5 / Q000097:blood; D008221:Lymphoid Tissue / Q000502:physiology; D038041:Lymphopoiesis; D008297:Male; D008875:Middle Aged; D012038:Regeneration
D007074:Immunoglobulin G; D015848:Interleukin-5; D007371:Interferon-gamma