Fifth International Congress Drug Therapy in HIV Infection 22-26 October, 2000 Glasgow, UK

FUNCTIONAL SIGNIFICANCE OF CD4 CELL NUMBERS ON THE WAY DOWN VERSUS ON THE WAY UP

M.M. Lederman, H. Valdez, K. Medvik, D. Dorazio, R. Asaad, C. Pacheko and J. Sierra-Vladero
Case Western Reserve University, Cleveland, Ohio USA and Institute de Nutricion, Mexico

Int Cong Drug Therapy HIV 2000 Oct 22-26;5:Abstract No. PL7.4
AIDS 2000, Oct 22-26;14(Suppl. 4);S9

We compared immune phenotype and function in HIV-1 infected subjects matched for age, sex and CD4 cell count who were untreated (UN) or who had been treated with suppressive antiretroviral therapies (TR) for at least 6 months.

Ten pairs (14 male, 6 female) have been studied to date. Mean CD4 cell counts in UN (651 ± 399) and TR (623 ± 174) were comparable as were mean ages (36 and 38 years). Mean nadir CD4 cell count in TR was 187 ± 145 cells/ul and TR subjects had been on antiviral therapy for a median of 40 months (range 14–50). Mean plasma HIV-1 RNA in UN was 3.55 log₁₀ (whereas in all TR patients, levels were < 2.6 log₁₀. In UN and TR, the proportions of naïve CD4 cells (47% versus 50%) and memory CD4 cells (49% versus 40%) were comparable. UN subjects had more memory CD8 cells (47% versus 25%, P < 0.02) and more activated CD38+DR+ CD8+ cells (40% versus 20%, P < 0.03) than TR subjects. UN and TR had DTH responses to Candida (7/10 versus 6/10) and mumps (6/10 and 7/10) and responses were of comparable magnitude. Lymphocyte proliferative (LP) responses to Candida and CMV were comparable in UN and TR. LP responses to tetanus were higher in UN than in TR (Median SI = 34 versus 4; P < 0.05) but responses to M. avium were higher in TR than in UN (SI = 12 versus 4; P < 0.1) and responses to HIV core were also higher in TR than in UN (SI = 9 versus 1; P < 0.05).

CD4 cell numbers do not necessarily reflect the repertoire of CD4 cell recognition in treated and untreated HIV infection. While selected responses are well restored after suppression of HIV replication, others are not and this may reflect exposure to antigen and targeted effects of HIV replication on cell function.

Presenting author: M.M. Lederman

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2000-10-22
PL7-4

Originally published in AIDS Volume 14, Supplement 4 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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