title: Immune Activation While on Potent Antiretroviral Therapy Can Predict Subsequent CD4+ T-Cell Increases Through 15 Years of Treatment.
abstract: BACKGROUND
  While persistent T-cell activation has been cross-sectionally associated with poor CD4+ T-cell restoration in HIV-infected individuals maintaining antiretroviral treatment (ART)-mediated viral suppression, it remains unclear whether CD8+ T-cell activation is of predictive effect on CD4+ T-cell recovery.
  
  
  OBJECTIVE
  We assessed whether the extent of persistent CD8+ T-cell activation (% CD38+/HLA-DR+) in the first few years of ART-mediated viral suppression predicted subsequent CD4+ T-cell recovery in 95 subjects with up to 15 years of observation on suppressive ART.
  
  
  RESULTS
  Lower CD8+ T-cell activation and higher naïve CD4+ T-cell frequencies (CD45RA+/CD62L+) measured at year 3 to 5 after starting ART independently predicted greater subsequent CD4+ T-cell increases. The mean CD4 count increase from year 0 to year 5 and the increase to the average of year 10 to 15 in the low CD8 activation group (≤18.5%; mean = 13%) were 342 and 458 cells/mm,3 and the increases were 248 and 349 cells/mm3 for the high CD8 activation group (≯18.5%; mean = 29%) (P = .002 and P = .016, respectively, comparing groups). At years 10 to 15, the mean CD4 counts in the groups were 579 and 484 cells/mm3, respectively (P = .026).
  
  
  CONCLUSIONS
  These findings support the need to identify approaches to reduce immune activation in treated HIV disease.
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts 02115, USA. xzhang@sdac.harvard.edu
authors.forename: Xinyan
authors.initials: X
authors.lastname: Zhang
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hunt
authors.forename: Scott M
authors.initials: SM
authors.lastname: Hammer
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Cespedes
authors.forename: Kristine B
authors.initials: KB
authors.lastname: Patterson
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Bosch
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged
chemical_list: D019380:Anti-HIV Agents