BACKGROUND: Persistently reduced CD4(+) T-lymphocyte counts in the face of undetectable HIV viremia are seen in a sizable percentage of HIV-infected patients undergoing antiretroviral therapy (ART). We analyzed the immune correlates of this phenomenon. MATERIALS AND METHODS: Sixty-seven HIV-infected patients with undetectable viremia (<50 copies/microl) after more than 7 years of ART were enrolled in the study and divided into two groups (CD4 cell counts >500 cells/microl or <500 cells/microl). Duration of HIV infection (>16 years) was comparable. Peripheral blood mononuclear cell were stimulated with gag+env or with cytomegalovirus peptides. Activated T cells (Ki67(+)), Treg lymphocytes (CD4(+)/CD25high/Foxp3+), divided into naive and activated cells based on PD1 expression, interleukin (IL)-10 and transforming growth factor (TGF)-beta production, annexin V, activation of caspases 8 and 9, Toll-like receptor (TLR)2 and TLR4 expression on immune cells, and plasma lipopolysaccharide (LPS) concentration were analyzed. RESULTS: CD4(+)/Ki67(+) T cells; plasma LPS; total, naive, and activated Treg; TLR2-expressing and TLR4-expressing Treg; IL-10 production; and early and late apoptotic CD4 T cells, were significantly increased in patients with undetectable viremia and CD4 cell counts less than 500 cells/microl after more than 7 years of ART. As previously shown, CD4 nadir were also lower in these individuals. Immune activation, LPS concentration, Treg, and degree of apoptosis were negatively correlated with CD4 cell counts. CONCLUSION: Lack of CD4 recovery in individuals in whom ART suppresses HIV replication is associated with complex immune alterations. Immune activation, likely driven by altered gut permeability and resulting in augmented Treg activity could play a pivotal role in this process.
Immune activation, apoptosis, and Treg activity are associated with persistently reduced CD4+ T-cell counts during antiretroviral therapy / S. Piconi, D.L. Trabattoni, A. Gori, S. Parisotto, C. Magni, P. Meraviglia, A. Bandera, A. Capetti, G. Rizzardini, M.S. Clerici. - In: AIDS. - ISSN 0269-9370. - 24:13(2010 Aug 24), pp. 1991-2000.
|Titolo:||Immune activation, apoptosis, and Treg activity are associated with persistently reduced CD4+ T-cell counts during antiretroviral therapy|
PICONI, STEFANIA (Primo)
TRABATTONI, DARIA LUCIA (Secondo)
CLERICI, MARIO SALVATORE (Ultimo)
|Parole Chiave:||antiretroviral therapy; CD4\+ T lymphocytes; cytokines; HIV; immune activation; immunological nonresponders; lipopolysaccharide; PD-L1; PD1; toll-like receptor; Treg cells|
|Settore Scientifico Disciplinare:||Settore MED/04 - Patologia Generale|
|Data di pubblicazione:||24-ago-2010|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/QAD.0b013e32833c93ce|
|Appare nelle tipologie:||01 - Articolo su periodico|