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Changes in levels of immune activation and reconstitution markers among HIV-1-infected Africans receiving antiretroviral therapy.
AIDS 2003;17(Suppl 3):S17-S22.
Koblavi-Dème S, Maran M, Kabran N, Borget MY, Kalou M, Kestens
L, Maurice C, Sassan-Morokro M, Ekpini ER, Roels TH, Chorba T, Nkengasong
JN.
Abstract
OBJECTIVE: To describe changes in immune activation and reconstitution markers
among HIV-1-infected patients receiving antiretroviral therapy (ART) in Abidjan,
Cote d'Ivoire. METHODS: Between November 1998 and February 2001, we analyzed
changes in immune activation and reconstitution markers among 52 patients.
Good virologic responders (n = 26) were defined as those who had suppressed
and maintained plasma viral load (VL) below the detection limit of the assay
for at least 12 months. Poor virologic responders (n = 26) were defined as
those with a detectable VL at 6 and 12 months after beginning ART. RESULTS:
Of the 26 good virologic responders, 20 (77%) were on highly active antiretroviral
therapy (HAART) compared with one (4%) of the poor responders. Among the
26 good responders, baseline median levels of CD38+CD8+ T cells were elevated,
but had decreased significantly at 6 months (P < 0.001) and at 12 months
of therapy (P < 0.001). Median levels of HLA-DR+CD8+ T cells also decreased
from baseline at 6 months (P < 0.001) and at 12 months of therapy (P < 0.001).
Levels of CD62L+CD4+ T cells increased steadily during the 6 and 12 months
of therapy and reached levels observed among HIV-negative blood donors (P
= 0.07). Among the 26 poor responders, median levels of CD38+CD8+ T cells
decreased significantly at 12 months of therapy (P = 0.006), but were higher
than levels in blood donors (P = 0.005). Levels of HLA-DR+CD8+ T cells decreased
significantly at 12 months of therapy (P < 0.001). Levels of CD62L+CD4+
decreased over time. CONCLUSION: Our results suggest that HAART can be successfully
used in African populations with elevated baseline immune activation markers.
