Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptions
<p>Abstract</p> <p>Background</p> <p>The common response to stopping anti-HIV treatment is an increase of HIV-RNA load and decrease in CD4<sup>+</sup>, but not all the patients have similar responses to this therapeutic strategy. The aim was to identify pred...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2008-02-01
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| Series: | BMC Infectious Diseases |
| Online Access: | http://www.biomedcentral.com/1471-2334/8/20 |
| _version_ | 1818258857200189440 |
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| author | Gonzalez-García Juan Rubio Rafael Moreno Ana de Quiros Juan Moreno Santiago Resino Salvador Seoane Elena Arribas José Pulido Federico Muñoz-Fernández Ma Ángeles |
| author_facet | Gonzalez-García Juan Rubio Rafael Moreno Ana de Quiros Juan Moreno Santiago Resino Salvador Seoane Elena Arribas José Pulido Federico Muñoz-Fernández Ma Ángeles |
| author_sort | Gonzalez-García Juan |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The common response to stopping anti-HIV treatment is an increase of HIV-RNA load and decrease in CD4<sup>+</sup>, but not all the patients have similar responses to this therapeutic strategy. The aim was to identify predictive markers of CD4<sup>+ </sup>cell count declines to < 350/μL in CD4-guided antiretroviral treatment interruptions.</p> <p>Methods</p> <p>27 HIV-infected patients participated in a prospective multicenter study in with a 24 month follow-up. Patients on stable highly active antiretroviral therapy (HAART), with CD4<sup>+ </sup>count > 600/μL, and HIV-RNA < 50 copies/ml for at least 6 months were offered the option to discontinue antiretroviral therapy. The main outcome was a decline in CD4<sup>+ </sup>cell count to < 350/μL.</p> <p>Results</p> <p>After 24 months of follow-up, 16 of 27 (59%) patients (who discontinued therapy) experienced declines in CD4<sup>+ </sup>cell count to < 350/μL. Patients with a CD4<sup>+ </sup>nadir of < 200 cells/μL had a greater risk of restarting therapy during the follow-up (RR (CI95%): 3.37 (1.07; 10.36)). Interestingly, lymphoproliferative responses to <it>Mycobacterium tuberculosis </it>purified protein derivative (PPD) below 10000 c.p.m. at baseline (4.77 (1.07; 21.12)), IL-4 production above 100 pg/mL at baseline (5.95 (1.76; 20.07)) in PBMC cultured with PPD, and increased IL-4 production of PBMC with p24 antigen at baseline (1.25 (1.01; 1.55)) were associated to declines in CD4<sup>+ </sup>cell count to < 350/μL.</p> <p>Conclusion</p> <p>Both the number (CD4<sup>+ </sup>nadir) and the functional activity of CD4<sup>+ </sup>(lymphoproliferative response to PPD) predict the CD4<sup>+ </sup>decrease associated with discontinuation of ART in patients with controlled viremia.</p> |
| first_indexed | 2024-12-12T18:06:12Z |
| format | Article |
| id | doaj.art-ce84d8b10926478e92ac40abe60e7c92 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T18:06:12Z |
| publishDate | 2008-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-ce84d8b10926478e92ac40abe60e7c922022-12-22T00:16:28ZengBMCBMC Infectious Diseases1471-23342008-02-01812010.1186/1471-2334-8-20Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptionsGonzalez-García JuanRubio RafaelMoreno Anade Quiros JuanMoreno SantiagoResino SalvadorSeoane ElenaArribas JoséPulido FedericoMuñoz-Fernández Ma Ángeles<p>Abstract</p> <p>Background</p> <p>The common response to stopping anti-HIV treatment is an increase of HIV-RNA load and decrease in CD4<sup>+</sup>, but not all the patients have similar responses to this therapeutic strategy. The aim was to identify predictive markers of CD4<sup>+ </sup>cell count declines to < 350/μL in CD4-guided antiretroviral treatment interruptions.</p> <p>Methods</p> <p>27 HIV-infected patients participated in a prospective multicenter study in with a 24 month follow-up. Patients on stable highly active antiretroviral therapy (HAART), with CD4<sup>+ </sup>count > 600/μL, and HIV-RNA < 50 copies/ml for at least 6 months were offered the option to discontinue antiretroviral therapy. The main outcome was a decline in CD4<sup>+ </sup>cell count to < 350/μL.</p> <p>Results</p> <p>After 24 months of follow-up, 16 of 27 (59%) patients (who discontinued therapy) experienced declines in CD4<sup>+ </sup>cell count to < 350/μL. Patients with a CD4<sup>+ </sup>nadir of < 200 cells/μL had a greater risk of restarting therapy during the follow-up (RR (CI95%): 3.37 (1.07; 10.36)). Interestingly, lymphoproliferative responses to <it>Mycobacterium tuberculosis </it>purified protein derivative (PPD) below 10000 c.p.m. at baseline (4.77 (1.07; 21.12)), IL-4 production above 100 pg/mL at baseline (5.95 (1.76; 20.07)) in PBMC cultured with PPD, and increased IL-4 production of PBMC with p24 antigen at baseline (1.25 (1.01; 1.55)) were associated to declines in CD4<sup>+ </sup>cell count to < 350/μL.</p> <p>Conclusion</p> <p>Both the number (CD4<sup>+ </sup>nadir) and the functional activity of CD4<sup>+ </sup>(lymphoproliferative response to PPD) predict the CD4<sup>+ </sup>decrease associated with discontinuation of ART in patients with controlled viremia.</p>http://www.biomedcentral.com/1471-2334/8/20 |
| spellingShingle | Gonzalez-García Juan Rubio Rafael Moreno Ana de Quiros Juan Moreno Santiago Resino Salvador Seoane Elena Arribas José Pulido Federico Muñoz-Fernández Ma Ángeles Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptions BMC Infectious Diseases |
| title | Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptions |
| title_full | Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptions |
| title_fullStr | Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptions |
| title_full_unstemmed | Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptions |
| title_short | Immunological predictors of CD4<sup>+ </sup>T cell decline in antiretroviral treatment interruptions |
| title_sort | immunological predictors of cd4 sup sup t cell decline in antiretroviral treatment interruptions |
| url | http://www.biomedcentral.com/1471-2334/8/20 |
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