T cell subsets in HIV infected patients after successful combination antiretroviral therapy: impact on survival after 12 years.

<h4>Objectives</h4>Immune activation is decreased by combination antiretroviral therapy (cART) in patients infected with human immunodeficiency virus (HIV), but residual activation remains and has been proposed as a cause of premature aging and death, but data are lacking. We analyzed th...

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Autores principales: Frederikke Falkencrone Rönsholt, Sisse Rye Ostrowski, Terese Lea Katzenstein, Henrik Ullum, Jan Gerstoft
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2012
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Acceso en línea:https://doaj.org/article/d5720b131d964f69a8a75b50d2792b0f
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Sumario:<h4>Objectives</h4>Immune activation is decreased by combination antiretroviral therapy (cART) in patients infected with human immunodeficiency virus (HIV), but residual activation remains and has been proposed as a cause of premature aging and death, but data are lacking. We analyzed the relationship between T-cell subsets after 18 months of cART and overall survival during 12 years of follow up.<h4>Methods</h4>A cohort of 101 HIV infected patients who had undetectable plasma HIV after starting cART was included in 1997-1998. T cell subsets were analyzed by flowcytometry after 18 months of cART. Relation to survival was calculated using Kaplan-Meier curves and multiple Cox regression.<h4>Results</h4>Seventeen patients died during the observation period. The leading causes of death were non-AIDS cancer and cardiovascular disease. Higher levels of CD8 memory T cells (CD8+,CD45RO+,CD45RA-) showed a significant beneficiary effect on survival, HR of 0.95 (95% confidence interval 0.91-0.99, P = 0.016) when adjusted for age, nadir CD4 count, CD4 count, and AIDS and hepatitis C status. T cell activation was not associated with increased risk of death.<h4>Conclusions</h4>Larger and longitudinal studies are needed to accurately establish prognostic factors, but overall results seem to suggest that prognostic information exists within the CD8 compartment.