AEGiS-14IAC: Immunologic and virologic factors at baseline may predict response to structured therapy interruption in early stage chronic HIV-1 infection.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Immunologic and virologic factors at baseline may predict response to structured therapy interruption in early stage chronic HIV-1 infection.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrB1438)

Garcia F, Plana M, Mestre G, Gil C, Cruceta A, Arostegui JI, Arnedo M, Miro JM, Joseph J, Pumarola T, Gallart T, Gatell JM
Infectious Diseases Unit Hospital Clinic, Barcelona, Spain

BACKGROUND: To analyze immunologic and virologic predictors of response to STI in 3 Spanish pilots studies in CHI patients in early stage.

METHODS: 44 chronic HIV-1-infected patients were treated with diverse regimens of STI. Plasma and tonsillar tissue VL, lymphocyte immunophenotyping and LPR to mitogens, and specific antigens and HIV-1 specific CTL responses were assessed at baseline. Response was defined as a VL set-point after 6 months off ART after the last interruption <= 5,000 copies/ml and 0.5 log10 < BVL before any ART and presence of specific CTL and helper response against HIV-1 antigens.

RESULTS: After STI, patients (n=44) were classified as follow: 18 (41%) had a response, and 26 (59%) no response. In the univariate analysis patients who responded had a significantly lower level of CD4+CD38+ and CD4+ naïve T cells and a higher level of memory CD4+ T cells and proliferative response to tetanus toxoid (TT) and p24 HIV-1 Ag than non-responder patients. A model incorporating 5 qualitative variables transformed according to the median value (CD4+CD38+, CD4+ naïve and memory T cells and stimulation index to TT and to p24 HIV-1 Ag) at baseline can classify correctly a 97% of patients (p= 0.0001). Tonsillar tissue VL, CD8+ T cell subsets, proliferative response to mitogens or CTL responses at baseline were not predictors of progression.

CONCLUSIONS: A high baseline level of memory CD4+ T cells and the presence of a proliferative response to recall antigens above the median may predict a good response to STI, suggesting that preserved memory response in CD4+ could be the most important factor to obtain response after STI.

Keywords: AEGIS, HIV-1, Antiretroviral Therapy, Highly Active, CD4-Positive T-Lymphocytes, Drug Therapy, Combination, T-Lymphocyte Subsets, Human, virology, immunology, therapy, drug therapyKWDaegis,hiv-1,antiretroviraltherapy,highlyactive,cd4-positivet-lymphocytes,drugtherapy,combination,t-lymphocytesubsets,human,virology,immunology,therapy,drugtherapy

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ThOrB1438

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.