  
T-cell activation identified in HIV-infected patients with viral relapse
Last Updated: 2001-05-02 18:59:26 EDT (Reuters Health)
By Anthony J. Brown, MD
WESTPORT, CT (Reuters Health) - Antiretroviral-treated HIV-infected patients who experience viral relapse, yet have stable CD4+ cell counts, show significant activation of CD8+ and CD4+ lymphocytes.
In a study reported in the May 15th issue of The Journal of Infectious Diseases, Dr. John A. Bartlett and colleagues from the Duke University Medical Center in Durham, North Carolina compared the immunologic profiles of 10 HIV-infected patients with stable CD4+ cell counts and viral suppression to those of 18 similar patients with viral relapse. Both groups had similar antiretroviral treatment histories.
The researchers found that CD8+ lymphocyte activation and CD38 antibody-binding capacity were significantly elevated in the subjects with viral relapse compared with those without relapse.
"Our study represents the first attempt to define the relevant pathogenetic issues between viral relapse and what is occurring in the immune system," Dr. Bartlett told Reuters Health. "The take-home message is that CD4+ cell numbers were clearly stable in these patients and that they had evidence of activation of CD8+ lymphocytes and also CD4+ lymphocytes that was directly related to increasing levels of HIV RNA."
"The real question now is, at what point does a fall in functional immunity occur?" Dr. Bartlett continued. "In other studies looking at the initiation of antiretroviral treatment, activation is key. The less activation that occurs, the better the functional status of the immune system."
Dr. Bartlett believes that "someday we will put all this information together, and get a sense of when you should switch a patient off of a failing antiretroviral regimen."
J Infect Dis 2001;183:1522-1525.
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