title: Increased Regulatory T-Cell Percentage Contributes to Poor CD4(+) Lymphocytes Recovery: A 2-Year Prospective Study After Introduction of Antiretroviral Therapy.
abstract: Background.  The primary aim of this study was to determine the impact of regulatory T cells (Tregs) percentage on immune recovery in human immunodeficiency virus (HIV)-infected patients after antiretroviral therapy introduction. Methods.  A 2-year prospective study was conducted in HIV-1 chronically infected naive patients with CD4 count <500 cells/mm(3). Regulatory T cells were identified as CD4(+)CD25(high)CD127(low) cells among CD4(+) lymphocytes. Effect of Treg percentage at inclusion on CD4 evolution overtime was analyzed using a mixed-effect Poisson regression for count data. Results.  Fifty-eight patients were included (median CD4 = 293/mm(3), median Treg percentage = 6.1%). Percentage of Treg at baseline and CD4 nadir were independently related to the evolution of CD4 absolute value according to time: (1) at any given nadir CD4 count, 1% increase of initial Treg was associated with a 1.9% lower CD4 absolute value at month 24; (2) at any given Treg percentage at baseline, 10 cell/mm(3) increase of CD4 nadir was associated with a 2.4% increase of CD4 at month 24; and (3) both effects did not attenuate with time. The effect of Treg at baseline on CD4 evolution was as low as the CD4 nadir was high. Conclusions.  Regulatory T-cell percentage at baseline is a strong independent prognostic factor of immune recovery, particularly among patients with low CD4 nadir.
authors.affiliation: Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France ; Infectious and Tropical Disease Unit ; Lyon-1 University ; Centre International de Recherche en Infectiologie , Centre CNRS U1111 (INSERM ) - UMR5308, ENS de Lyon, UCBL1.
authors.forename: Julien
authors.initials: J
authors.lastname: Saison
authors.affiliation: Lyon-1 University ; Service de Biostatistique , Hospices Civils de Lyon ; Equipe Biostatistique Santé CNRS UMR 5558 , Villeurbanne.
authors.forename: Delphine
authors.initials: D
authors.lastname: Maucort Boulch
authors.affiliation: Infectious and Tropical Disease Unit ; Lyon-1 University ; Centre International de Recherche en Infectiologie , Centre CNRS U1111 (INSERM ) - UMR5308, ENS de Lyon, UCBL1.
authors.forename: Christian
authors.initials: C
authors.lastname: Chidiac
authors.affiliation: Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France.
authors.forename: Julie
authors.initials: J
authors.lastname: Demaret
authors.affiliation: Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Malcus
authors.affiliation: Infectious and Tropical Disease Unit.
authors.forename: Laurent
authors.initials: L
authors.lastname: Cotte
authors.affiliation: Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France.
authors.forename: Francoise
authors.initials: F
authors.lastname: Poitevin-Later
authors.affiliation: Infectious and Tropical Disease Unit.
authors.forename: Patrick
authors.initials: P
authors.lastname: Miailhes
authors.affiliation: Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France ; Lyon-1 University.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Venet
authors.affiliation: Virology Laboratory , Hospices Civils de Lyon, Hôpital Croix-Rousse , France.
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Trabaud
authors.affiliation: Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France ; Lyon-1 University.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Monneret
authors.affiliation: Infectious and Tropical Disease Unit ; Lyon-1 University ; Centre International de Recherche en Infectiologie , Centre CNRS U1111 (INSERM ) - UMR5308, ENS de Lyon, UCBL1.
authors.forename: Tristan
authors.initials: T
authors.lastname: Ferry
keywords: ART; T-regulatory cells; immune response; immunological failure; nadir CD4