Immunity in HIV-1-infected adults with a previous state of moderate-severe immune-suppression and more than 500 CD4+ T cell after highly active antiretroviral therapy

J Clin Immunol. 2004 Jul;24(4):379-88. doi: 10.1023/B:JOCI.0000029112.82425.59.

Abstract

We evaluated phenotypic and functional parameters of immune restoration of 27 HIV-infected patients on highly active antiretroviral therapy (HAART) (HIV-cases) with HIV-RNA levels below detectable limits at least during 18 months, and CD4+ cell per microliter higher than 500 at the moment of the study and lower than 300 anytime before. These patients were compared with 11 HIV-controls that never had less than 500 CD4+ cell per microliter and 20 healthy-controls (HIV seronegative subjects) in a cross-sectional study. HIV-cases had lower counts of naïve CD4+ than HIV-controls and healthy-controls. HIV-patients (both HIV-cases and HIV-controls) showed higher values of naïve and memory CD8+ counts than healthy-controls. TREC-bearing cell levels were significantly lower in HIV-cases than in healthy-controls. Peripheral blood mononuclear cells (PBMC) cultures, HIV-cases had lower values in proliferation to streptokinase (SK) and tetanus toxin (TT) than in healthy-controls. HIV-cases had lower IFN-gamma and higher IL-5 production with pokeweed than healthy-controls ( P < 0.01). However, IL-5 production of HIV-cases after TT stimulation was lower than in HIV-controls and healthy-controls. Total IgG and IgG1 levels were significantly higher in HIV-cases than in HIV-controls and healthy-controls. Also, IgM levels were significantly higher in HIV-cases than in healthy-controls. Nevertheless, IgG2 levels were significantly lower in HIV-cases and HIV-controls than in healthy-controls. The levels of specific Igs antipneumococcal capsular polysaccharide and TT were significantly lower in HIV-cases than in healthy-controls. HIV-patients with a previous state of severe-moderate immunosuppression normalizing their CD4+ counts have a incomplete immune reconstitution after HAART. Long-term consequences of this subclinical immune deficiency remain to be determined.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active*
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Cell Proliferation
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / immunology*
  • Humans
  • Immunity*
  • Immunoglobulin G / classification
  • Immunosuppression Therapy*
  • Interferon-gamma / blood
  • Interleukin-5 / blood
  • Lymphoid Tissue / physiology
  • Lymphopoiesis
  • Male
  • Middle Aged
  • Regeneration

Substances

  • Immunoglobulin G
  • Interleukin-5
  • Interferon-gamma