PARISI SG, BIASIN M, SARMATI L, MAZZI R, CONCIA E, BOASSO A, ANDREONI M, UCCELLA I, CLERICI M; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother.
2001 Dec 16-19; 41: abstract no. I-1943.
Universita di Verona, Verona, Italy
Objective: Quantitative immunovirologic parameters were evaluated in 7 early HAART treated patients (>500 CD4/mL) and in 3 naive untreated patients. METHODS: 7 naive, HAART treated (Htr) early patients and 3 naive not treated (Ntr) patients; baseline HIV plasma viremia was <5000 copies in 5/7 Htr and in Ntr patients. Plasma viremia, proviral DNA, CD4 cell counts and % as well as CXCR4 and CCR5-specific mRNA were evaluated at baseline and during therapy. Results from the baseline and 40 months of therapy are reported. RESULTS: Plasma viremia at month 40 was undetectable (<20 copies/ml) in 6/7 Htr. In these patients proviral DNA was greatly reduced (from 579 to 45 copies per 106 CD4), CD4 % increased significantly (from 32 to 39%), and a conspicuous reduction in the X4/R5 ratio was seen (from 894 to 325). Conversely, in the only patient failing HAART (lack of compliance) CD4 percentage were unmodified (from 31 to 33%) and an increase in proviral DNA (nadir from 40 to 122) and in the X4/R5 ratio (from 479 to 1821) was detected. Over 34 months Ntr patients remained stable in CD4 cells (from 31 to 30%), HIV-1 viral load and X4/R5 ratio markedly increased (from 1510 to 14460 and from 407 to 690, respectively). CONCLUSIONS: A tight correlation is detected between immunovirologic improvement during HAART and down regulation of the X4/R5 ratio. Preliminary data suggest that increased IFN-gamma production could be responsible for the augmented expression of R5. While Ntr patients have an increasing plasma viremia and X4/R5 ratio, the decrease in X4/R5 ratio continues over time in patients with undetectable viral load and could represent a surrogate marker of prognostic value.
- Acquired Immunodeficiency Syndrome
- Antigens, CD4
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- CD4-Positive T-Lymphocytes
- HIV Infections
- HIV Seropositivity
- Receptors, CCR5
- Receptors, CXCR4
- Viral Load
From Meeting Abstracts