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Baseline Naive CD4＋ T-cell Level Predicting Immune Reconstitution in Treated HIV-infected Late Presenters
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Baseline Naive CD4＋ T-cell Level Predicting Immune Reconstitution in Treated HIV-infected Late Presenters
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Journal Article
Baseline Naive CD4＋ T-cell Level Predicting Immune Reconstitution in Treated HIV-infected Late Presenters
2016
Overview
Background：Among HlV-infected patients initiating antiretroviral therapy （ART）,early changes in CD4＋ T-cell subsets are well described.However,HIV-infected late presenters initiating treatment present with a suboptimal CD4＋ T-cell reconstitution and remain at a higher risk for AIDS and non-AIDS events.Therefore,factors associated with CD4＋ T-cell reconstitution need to be determined in this population,which will allow designing effective immunotherapeutic strategies.Methods：Thirty-one adult patients with baseline CD4＋ T-cell count 〈350 cells/mm^3 exhibiting viral suppression after ART initiation were followed in the HIV/AIDS research center of Peking Union Medical College Hospital in Beijing,China,from October 2002 to September 2013.Changes in T-cell subsets and associated determinants were measured.Results：Median baseline CD4＋ T-cell count was 70 cells/mm3.We found a biphasic reconstitution ofT-cell subsets and immune activation：a rapid change during the first 6 months followed by a more gradual change over the subsequent 8 years.Baseline CD4＋ T-cell count 〉200 cells/ mm3 in comparison to CD4＋ T-cell count ≤200 cells/mm3 was associated with more complete immune Reconstitution （77.8% vs.27.3% respectively;P =0.017） and normalized CD4/CD8 ratio.We showed that the baseline percentage of naive CD4＋ T-cell was a predictive marker for complete immune reconstitution （area under receiver operating characteristic curve 0.907）,and 12.4% as cutoffvalue had a sensitivity of 84.6% and a specificity of 88.2%.Conclusions：Baseline naive CD4＋ T-cell percentage may serve as a predictive marker for optimal immune reconstitution during long-term therapy.Such study findings suggest that increasing thymic output should represent an avenue to improve patients who are diagnosed late in the course of infection.
Publisher
Wolters Kluwer India Pvt. Ltd,Medknow Publications and Media Pvt. Ltd,Lippincott Williams & Wilkins Ovid Technologies,Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China,Medknow Publications & Media Pvt Ltd,Wolters Kluwer
Subject
Acquired immune deficiency syndrome
/ Adult
/ Age
/ AIDS
/ Antiretroviral Therapy, Highly Active - methods
/ Antiretroviral Therapy; HIV; Immune Activation; Naive CD4+ T-cell; Thymic Function
/ CD4
/ CD4-Positive T-Lymphocytes - metabolism
/ Female
/ Highly active antiretroviral therapy
/ HIV
/ HIV Infections - drug therapy
/ HIV感染者
/ Human immunodeficiency virus
/ Humans
/ Male
/ Original
/ Studies
/ T cells
/ T-Lymphocyte Subsets - immunology
/ T细胞亚群
/ 免疫治疗
/ 后期
/ 基线
/ 细胞水平
/ 预测指标
