AEGiS-13IAC: Immunological reconstitution after triple antiretroviral therapy with two NRTIi combined with a PI or nevirapine in early asymptomatic chronic HIV-1 infection.

3 and plasma VL > 5000 c/ml was analysed. Twenty randomized patients from 2 cohort st" /> AEGiS-13IAC: Immunological reconstitution after triple antiretroviral therapy with two NRTIi combined with a PI or nevirapine in early asymptomatic chronic HIV-1 infection.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Immunological reconstitution after triple antiretroviral therapy with two NRTIi combined with a PI or nevirapine in early asymptomatic chronic HIV-1 infection.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrB486)

Montserrat P, Garcia F, Gallart T, Lejeune M, Martinez C, Maleno MJ, Aused R, Barceli JJ, Miri JM, Gatell JM
P. Montserrat, Hospital Clinic, Immunology Laboratory, Villarroel 170, 08036 Barcelona, Spain, Tel.: +34 93 227 55 86, Fax: +34 93 451 44 38, E-mail: fgarcia@medicina.ub.es

The effectiveness of two triple antiretroviral combinations to correct T-cell subsets abnormalities and to restore immune functions in asymptomatic antiretroviral naive HIV-1-infected patients with a baseline CD4 T-cell counts > 500/mm³ and plasma VL > 5000 c/ml was analysed. Twenty randomized patients from 2 cohort studies received either D4T + 3TC + Indinavir (PI) (n = 9), or D4T + ddI + Nevirapine (NEV) (n = 11) were studied. After one year of follow-up, the PI regimen was significantly more effective in reducing plasma and lymphoid tissue VL to undetectable levels. A significant increase in CD4+ T-cells was observed in patients treated with PI (p = 0,0007) when comaring with those treated with NEV. Percentages of CD8+ T-cells and of activated CD8+ T-cells (CD38+ and DR+ as well as memory CD45RO+) decreased in all patients. An increase of the CD28+ subset of CD8+ T-cells also occurred being statistically significant in the PI group. Naive (CD45RA+ CD45RO-) T-cells were maintained in the CD4+ subset and augmented in the CD8+ subset in all patients. In both PI and NEV groups, memory (CD45RA- CD45RO+) CD4+ T-cells increased significantly (p = 0,03). PBMC responsiveness to polyclonal stimuli (PHA, CD3, CD3 + CD28, or PWM) and to TT and CMV antigen was similar in both groups of treatment. HIV-infected patients treated for one year with both triple combinations lacked significant T-cell responsiveness to HIV-1 proteins. No significant differences were observed among the two treatment groups with respect to the percentages of IFN?, IL-2, TNF?, and IL-4- producing lymphocytes. Data support the convenience of starting with a PI regimen even in very early stages of chronic HIV-1 infection in order to achieve an almost complete normalisation of the immune system although additional therapeutic approaches should be envisaged to restore HIV-1-specific responses.

Keywords: AEGIS, HIV-1, Nevirapine, HIV Infections, CD4 Lymphocyte Count, CD8-Positive T-Lymphocytes, Antigens, CD45, T-Lymphocyte Subsets, Antigens, CD28, T-Lymphocytes, Antigens, CD8, Lamivudine, Antigens, CD3, Acquired Immunodeficiency Syndrome, ADP-ribosyl Cyclase, Cohort Studies, CD38 antigen, Human, immunology
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