AEGiS-05CROI: Immunologic changes in blood and lymph nodes induced by highly active antiretroviral therapy (HAART).

5th Conference on Retroviruses and Opportunistic Infections


Chicago, IL - February 1-5, 1998



Immunologic changes in blood and lymph nodes induced by highly active antiretroviral therapy (HAART).

Conf Retroviruses Opportunistic Infect 1998 Feb 1-5; 5th:83 (abstract no. 21)

Hicks CB, Markert L, Ottinger J, Ferrari G, Harmon L, Demarest J, Bartlett JA, Hale L, Weinhold K; Duke University Medical Center, Durham, NC.

Aim of Study: To assess lymphocyte immunophenotype and function in blood and lymph nodes (LN) following HAART in treatment naïve HIV-infected patients.

METHODS: Six patients (mean CD4 = 444 cells/mm3 [range 205-686] and mean HIV-1 RNA = 4.86 log10 copies/ml [range 3.77 - 5.37]) received AZT, 3TC, and ritonavir. Lymph node biopsies were obtained pretreatment and at 6 and 24 weeks into therapy. Flow cytometric analyses and CTL precursor frequencies were done on blood and LN. T-helper cell function was assessed by measuring responses to recall and neoantigens via lymphocyte proliferation assays (LPA).

RESULTS: Viral load became nondetectable (ND) in 5/6 patients. Mean CD4 increases at weeks 16 and 24 were 198 cells/mm3 and 121 cells/mm3 respectively. Decreases in activation markers (CD38 and to a lesser extent HLA-DR) were seen in blood and LN. CD8+ percentages declined and CD4+ percentages increased in LN, with lesser effects seen in blood. Decreases in memory phenotype (CD45RO+) were observed only among CD8+ cells in LN during the period of observation. Decreases were seen in percentages of CD4+ cells expressing CD28+CD95+ in LN and blood. Following immunization, improvement in LPA responses occurred in 4/6 to tetanus, and 2/6 patients mounted a de novo response to the neoantigen KLH. 5/6 showed improved Candida LPA responses. In the patients analyzed thus far, CTL responses and overall T-cell repertoire were maintained throughout the observation period. CTL precursor frequencies in peripheral blood were greater than those in LN.

CONCLUSIONS: HAART induces substantial changes in lymphocyte subsets in both blood and lymph nodes. These changes lead to improved immune function in some patients as assessed by responses to recall and neoantigens.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, Lymph Nodes, Viral Load, Anti-HIV Agents, Zidovudine, Antigens, CD45, Ritonavir, NAD+ Nucleosidase, Lamivudine, T-Lymphocytes, Antigens, Differentiation, Antigens, CD28, Antigens, CD4, T10 antigen, Human, blood, immunology, AIDS

1998-02-01
21

Copyright © 1998 - Foundation for Retrovirology and Human Health (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed from National Library of Medicine.