Tortajada C, Garcia F, Plana M, Gallart T, Maleno M J, Miró J M, Gatell J M
Infectious Diseases Unit and Immunology Laboratory, Institut d'Investigacions Biomediques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain.
J Acquir Immune Defic Syndr. 2000 Dec 1;25(4):296-305. doi: 10.1097/00042560-200012010-00002.
This research comprised a pilot open prospective clinical study comparing T-cell subset reconstitution in antiretroviral-naive patients, after 12 months of HAART when treatment was initiated in early stages (ES; n = 18) of infection versus advanced stages (AS; n = 20).
10 healthy HIV-negative individuals. Immunophenotypic markers were evaluated before and after 6-and 12-months' therapy. Functional assays were performed in one subset.
Viral load (VL) was < 200 copies/ml in all patients. Median percentages of CD4+ pretherapy were 33% and 6%, respectively, in the ES and AS groups, increment after 12 months of therapy was +15% and +13% respectively. Only the ES group achieved normal values. Declines of CD8+ percentage were significantly higher in the ES (-18%) than in the AS group (-2%). CD4+ memory and naive cells in the ES group were similar to those of controls before treatment and did not change after therapy. In contrast, CD4+ memory and naive cells in the AS group did not reach normal levels despite treatment. In the ES group, there was a significant increment in CD8+ naive cells (+8%) and a decrement in CD8+CD38+ cells (-17%), both populations reached values close to normal, whereas these subsets remained far from normal in the AS group. Improvement of lymphoproliferative response after therapy was observed in both groups. One patient in the ES group showed positive LPR against p24 after treatment. After 12 months' highly active antiretroviral therapy, only those who began such therapy in ES disease reached values within the range of healthy controls. To achieve a more complete immunologic reconstitution, early initiation of potent antiretroviral therapy should be recommended.
本研究包括一项开放性前瞻性临床研究，比较了初治抗逆转录病毒治疗的患者在感染早期（ES组；n = 18）与晚期（AS组；n = 20）开始接受12个月高效抗逆转录病毒治疗（HAART）后T细胞亚群的重建情况。
10名健康的HIV阴性个体。在治疗前以及治疗6个月和12个月后评估免疫表型标志物。在一个亚组中进行了功能测定。
所有患者的病毒载量（VL）均<200拷贝/ml。ES组和AS组治疗前CD4 +的中位数百分比分别为33%和6%，治疗12个月后的增幅分别为+15%和+13%。只有ES组达到了正常数值。ES组CD8 +百分比的下降（-18%）显著高于AS组（-2%）。ES组的CD4 +记忆细胞和初始细胞在治疗前与对照组相似，治疗后没有变化。相比之下，AS组的CD4 +记忆细胞和初始细胞尽管经过治疗仍未达到正常水平。在ES组中，CD8 +初始细胞显著增加（+8%），CD8 + CD38 +细胞减少（-17%），这两个群体的值均接近正常，而在AS组中这些亚群仍远未达到正常水平。两组治疗后淋巴细胞增殖反应均有改善。ES组有1名患者治疗后对p24显示出阳性淋巴细胞增殖反应（LPR）。经过12个月的高效抗逆转录病毒治疗后，只有那些在ES期开始治疗的患者达到了健康对照组范围内的值。为了实现更完全的免疫重建，建议尽早开始有效的抗逆转录病毒治疗。
