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T-Cell Subset Distribution in HIV-1–Infected Patients After 12 Years of Treatment-Induced Viremic Suppression

Rönsholt, Frederikke F. MD*; Ullum, Henrik MD, PhD; Katzenstein, Terese L. MD, PhD, DMSc*; Gerstoft, Jan MD, DMSc*; Ostrowski, Sisse R. MD, PhD, DMSc

JAIDS Journal of Acquired Immune Deficiency Syndromes: November 1st, 2012 - Volume 61 - Issue 3 - p 270–278
doi: 10.1097/QAI.0b013e31825e7ac1
Basic and Translational Science

Objective: Residual immune activation and skewed T cell maturation may contribute to excess comorbidity and mortality in successfully treated HIV-infected patients, and long-term effects of combination antiretroviral therapy (cART) on immune reconstitution remain a debated issue. Quantitative T cell reconstitution and activation and its association with residual viremia in patients with 12 years of viremic suppression were investigated.

Design: Blood samples collected cross-sectionally from 71 HIV-infected patients with cART-induced viremic suppression through 12 years were compared with samples from 16 healthy controls.

Methods: Several different subsets of naive, memory, and activated T cells were analyzed in fresh whole blood by 6-color flowcytometry, and ultrasensitive quantification of HIV RNA was performed.

Results: HIV-infected patients had lower absolute and relative CD4 T cell counts and higher absolute and relative CD8 T cell counts than controls. HIV-infected patients had lower concentrations of naive CD4 cells than controls, but proportions were similar. HIV-infected patients had higher concentrations of CD8+ T cells than controls in all the examined subsets but only a higher proportion of CD8+ cells in the intermediately differentiated and activated subsets. Residual viremia did not correlate to proportions of naive CD4, CD4 recent thymic emigrants, or activated CD8 T cells.

Conclusions: This study demonstrated some degree of T cell imbalance even after 12 years of successful cART. Large longitudinal studies are needed to establish whether these discrete changes have clinical relevance.

*Department of Infectious Diseases

Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark.

Correspondence to: Frederikke F. Rönsholt, MD, Department of Infectious Diseases, Rigshospitalet, 5132, Blegdamsvej 9, 2100 Copenhagen, Denmark (e-mail: frederikkefr@gmail.com).

Supported by the Danish Medical Research Council, The Danish AIDS Foundation, A.P. Møller and wife Chastine Mc-Kinney Møllers Foundation (Fonden til Lægevidenskabens Fremme), and the Augustinus Foundation.

The authors have no conflicts of interest to disclose.

Received February 06, 2012

Accepted May 04, 2012

© 2012 Lippincott Williams & Wilkins, Inc.