Introduction: Non-nucleoside reverse transcriptase inhibitors (NNRTI) have emerged as a potentially better tolerated alternative to protease inhibitors (PI) in highly active antiretroviral therapy (HAART). Alterations in CC chemokine profiles are thought to be important markers of immune reconstitution following successful HAART. Here, we have compared CC chemokine mRNA levels from native peripheral blood mononucleated cells (PBMC) before and 6 months after the initiation of two different HAART regimens.
Patients: Group 1 (n=11) was treated with triple therapy consisting of two nucleoside analogues an the PI indinavir; group 2 (n=8) was treated with triple therapy including the NNRTI efavirenz instead of PI.
Methods: CC chemokine mRNA levels (RANTES, MIP-1 alpha, MIP1- beta, MCP-1, MCP-2) were determined from native PBMC before and 6 months after the initiation of HAART using a previously described reverse transcription / real time PCR assay (Dumoulin et al., J Immunol Methods 241: 109). In addition, HIV viral load and CD4 cell count were determined by commercially available methods. Values were compared with the Wilcoxon test for paired samples.
Results: In both groups a reduction in viral load and an increase in CD4 cell count were observed (p<0.01). The mRNA levels of MIP-1 alpha, MIP-1 beta and MCP-1 were significantly decreased in both groups (p<0.05) while MCP-2 mRNA was increased after 6 months of treatment. In contrast, no significant changes in RANTES mRNA levels were observed.
Conclusion: The data suggest that HAART regiments containing NNRTI instead of PI are equally effective with regards to modification of chemokine profiles during immune reconstitution.
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