title: T-cell subset distribution in HIV-1-infected patients after 12 years of treatment-induced viremic suppression.
abstract: OBJECTIVE
  Residual immune activation and skewed T cell maturation may contribute to excess comorbidity and mortality in successfully treated HIV-infected patients, and long-term effects of combination antiretroviral therapy (cART) on immune reconstitution remain a debated issue. Quantitative T cell reconstitution and activation and its association with residual viremia in patients with 12 years of viremic suppression were investigated.
  
  
  METHODS
  Blood samples collected cross-sectionally from 71 HIV-infected patients with cART-induced viremic suppression through 12 years were compared with samples from 16 healthy controls.
  
  
  METHODS
  Several different subsets of naive, memory, and activated T cells were analyzed in fresh whole blood by 6-color flowcytometry, and ultrasensitive quantification of HIV RNA was performed.
  
  
  RESULTS
  HIV-infected patients had lower absolute and relative CD4 T cell counts and higher absolute and relative CD8 T cell counts than controls. HIV-infected patients had lower concentrations of naive CD4 cells than controls, but proportions were similar. HIV-infected patients had higher concentrations of CD8 T cells than controls in all the examined subsets but only a higher proportion of CD8 cells in the intermediately differentiated and activated subsets. Residual viremia did not correlate to proportions of naive CD4, CD4 recent thymic emigrants, or activated CD8 T cells.
  
  
  CONCLUSIONS
  This study demonstrated some degree of T cell imbalance even after 12 years of successful cART. Large longitudinal studies are needed to establish whether these discrete changes have clinical relevance.
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. frederikkefr@gmail.com
authors.forename: Frederikke F
authors.initials: FF
authors.lastname: Rönsholt
authors.forename: Henrik
authors.initials: H
authors.lastname: Ullum
authors.forename: Terese L
authors.initials: TL
authors.lastname: Katzenstein
authors.forename: Jan
authors.initials: J
authors.lastname: Gerstoft
authors.forename: Sisse R
authors.initials: SR
authors.lastname: Ostrowski
mesh_terms: D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000187:drug effects*; D019562:Viral Load / Q000187:drug effects; D014766:Viremia / Q000188:drug therapy / Q000276:immunology