title: Relevance of CD38 expression on CD8 T cells to evaluate antiretroviral therapy response in HIV-1-infected youths.
abstract: Surrogate markers for monitoring immuno-virological discordant responders, in addition to plasma viral load and CD4 cells, are still lacking. We assessed the diagnostic utility of CD38 expression on CD8 T cell assay, alone or in association with lymphocyte proliferation to mycotic antigens, in evaluating antiretroviral response. 28 vertically HIV-infected youths, 21 HAART- and seven 2 nucleotide reverse transcriptase inhibitors-treated, were enrolled in a retrospective study. Responders (57.1%) and non-responders (42.9%) to stable antiretroviral therapy for a minimum of 6 months, on the basis of viral load and CD4 T cells, comprehensively evaluated by CD38 expression on CD8 T lymphocytes [measured as CD38 antibody bound per CD8 T cell (CD38 ABC) and %CD38+ of total CD8 T cells (%CD38/CD8)] and lymphocyte proliferation to P. jiroveci, C. albicans, C. neoformans, A. fumigatus at a single time point after treatment, were selected. CD38 expression > or =2401 CD38 ABC and > or =85% CD38/CD8 cut-off points, accurately discriminates responders versus non-responders, both measures resulting in 75.0% (CI 42.8-94.5) sensitivity (identification of non-responder) and 93.8% (CI 69.8-99.8) specificity (identification of responder), when considered as single assays. The association '> or =2401 CD38 ABC or > or =85% CD38/CD8' improved sensitivity to 83.3% (CI 51.6-97.9), while the association '<2401 CD38ABC (or <85% CD38/CD8) and lymphoproliferative response positive to > or =2 tested organisms' improved specificity to 100% (CI 79.4-100). In conclusions, CD38 expression and mycotic antigen-specific T-cell proliferation may be used as additional parameters to existing criteria to evaluate antiretroviral response in immuno-virological discordant patients.
authors.affiliation: Infectious Diseases Clinic, University of Genoa, San Martino Hospital, Genova, Italy. raffaella.rosso@unige.it
authors.forename: R
authors.initials: R
authors.lastname: Rosso
authors.forename: D
authors.initials: D
authors.lastname: Fenoglio
authors.forename: M P
authors.initials: MP
authors.lastname: Terranova
authors.forename: F
authors.initials: F
authors.lastname: Lantieri
authors.forename: D
authors.initials: D
authors.lastname: Risso
authors.forename: E
authors.initials: E
authors.lastname: Pontali
authors.forename: M
authors.initials: M
authors.lastname: Setti
authors.forename: A
authors.initials: A
authors.lastname: Cossarizza
authors.forename: J L
authors.initials: JL
authors.lastname: Ravetti
authors.forename: C
authors.initials: C
authors.lastname: Viscoli
authors.forename: A
authors.initials: A
authors.lastname: Kunkl
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000032:analysis / Q000502:physiology*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000293:Adolescent; D000946:Antigens, Fungal / Q000276:immunology; D023241:Antiretroviral Therapy, Highly Active; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002648:Child; D005260:Female; D015497:HIV-1; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis / Q000502:physiology*; D012372:ROC Curve
chemical_list: D000946:Antigens, Fungal; D008562:Membrane Glycoproteins; C498154:CD38 protein, human; D051997:ADP-ribosyl Cyclase 1