T Cell Activation Is Associated with Lower CD4+T Cell Gains in Human Immunodeficiency Virus–Infected Patients with Sustained Viral Suppression during Antiretroviral Therapy

作者：Peter W. Hunt, Jeffrey N. Martin, Elizabeth Sinclair, Barry M. Bredt, Elilta Hagos, Harry W. Lampiris, Steven G. Deeks · 发表于：The Journal of Infectious Diseases · 年份：2003 · DOI：10.1086/374786 · 被引用次数：854 · 研究领域：HIV Research and Treatment、HIV/AIDS drug development and treatment、Immune Cell Function and Interaction

Although T cell activation is associated with disease progression in untreated human immunodeficiency virus type 1 (HIV-1) infection, its significance in antiretroviral-treated patients is unknown. Activated (CD38+HLA-DR+) T cell counts were measured in 99 HIV-infected adults who had maintained a plasma HIV RNA level ⩽1000 copies/mL for a median of 21 months while receiving antiretroviral therapy. Patients with sustained viral suppression had lower levels of T cell activation than untreated patients but higher levels than HIV-uninfected control subjects. Persistent T cell activation was associated with decreased CD4+ T cell gains during therapy. For every 5% increase in the proportion of activated CD8+ T cells, 35 fewer CD4+ T cells/mm3 were gained. Increased T cell activation was associated with shorter duration of viral suppression, hepatitis C virus coinfection, frequent low-level viremia, and lower nadir CD4+ T cell counts. Interventions that directly target T cell activation or the determinants of activation may prove to be useful adjuvants to antiretroviral therapy