AIDS Study on antiretroviral therapy initiation

AIDS Study on antiretroviral therapy initiation

The objective of this study was to examine HIV specific CD8+ T cells from patients with primary HIV infection and other antiretroviral therapy initiation, which were evaluated for CD 127 expression and proliferating capacity and were compared with cells from chronically-infected patients including long-term nonprogressors and HIV elite controllers.

Thirty patients were studied with primary HIV infection and 33 patients were studied with chronic HIV infection including nonprogressors and elite controllers. HIV-specific CD8+ cells were identified by costaining with HIV human leukocyte antigen Class 1 pentamers. CD127 expression was assed by flow cytometry and cell proliferation for carboxyfluorescein succinimidyl ester labeling.

The results showed that during Primary HIV infection most HIV specific CD8+ T cells coexpressed CD27 and CD45RO and were highly activated. Their CD127 expression was very low and correlated negatively with both HIV RNA and DNA levels and with expression of the activation marker CD38. CD127 expression correlated positively with CD4 cell count. Some CD127 expression was observed in the two groups of chronically-infected nonprogressors. CD127 expression on HIV specific CD8+ T cells increased in early-treated primary HIV patients, matching levels similar to those observed in nonprogoressors. In parallel, these cells acquired strong proliferating capacity. No change in CD127 expression or proliferative potential was observed in untreated patients.

The conclusion of this study was that early antiretroviral therapy initiation enhances CD127 expression on HIV-specific CD8+ T cells, reaching levels similar to those observed in aviremic nonprogressors and restores their proliferative capacity allowing them to fight HIV.

This is an interesting study. The only problem is that early HIV infection is hardly ever found. Most patients have well-established infections when they are discovered to be HIV positive and some of them are discovered late in the course of HIV infection.