title: Early changes in T-cell activation predict antiretroviral success in salvage therapy of HIV infection.
abstract: OBJECTIVE
  Because effective antiretroviral therapy (ART) reduces immune activation, we hypothesize that early changes in immune activation are associated with subsequent virologic response to therapy.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Institutional HIV clinic.
  
  
  METHODS
  Thirty-four adult HIV patients with virologic failure on their current antiretroviral regimen.
  
  
  METHODS
  Change to salvage regimen selected by patient's physician.
  
  
  METHODS
  Measures of immune activation at baseline and at 2, 4, 8, and 24 weeks after enrollment. Data were analyzed by proportional hazards (PH) models.
  
  
  RESULTS
  PH models showed that reductions between baseline and week 2 in expression of CD38 (P = 0.02) or CD95 (P = 0.02) on CD4 T cells were associated with increased likelihood of achieving virologic suppression. Kaplan-Meier analysis demonstrated that patients who had reductions within the first 2 weeks of therapy in CD4 T-cell expression of CD38 (P = 0.003) or CD95 (P = 0.08) were more likely to achieve viral suppression than those who did not.
  
  
  CONCLUSIONS
  Reduced CD4 T-cell expression of CD38 and CD95 occurring within 2 weeks of salvage therapy is associated with subsequent viral suppression. Monitoring CD38 and CD95 may allow earlier assessment of the response to ART.
authors: Mayo Clinic, Rochester, MN 55905, USA.
authors: Brett D
authors: BD
authors: Shepard
authors: Mona R
authors: MR
authors: Loutfy
authors: Janet
authors: J
authors: Raboud
authors: Frank
authors: F
authors: Mandy
authors: Colin M
authors: CM
authors: Kovacs
authors: Christina
authors: C
authors: Diong
authors: Michele
authors: M
authors: Bergeron
authors: Victoria
authors: V
authors: Govan
authors: Stacey A
authors: SA
authors: Rizza
authors: Jonathan B
authors: JB
authors: Angel
authors: Andrew D
authors: AD
authors: Badley
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000032:analysis; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D013601:T-Lymphocytes / Q000276:immunology*; D019014:fas Receptor / Q000032:analysis
chemical_list: D019380:Anti-HIV Agents; D019014:fas Receptor; D051997:ADP-ribosyl Cyclase 1