Koblavi-Dème Stéphania, Maran Matthieu, Kabran Nguessan, Borget Marie Yolande, Kalou Mireille, Kestens Luc, Maurice Chantal, Sassan-Morokro Madeleine, Ekpini Ehounou R, Roels Thierry H, Chorba Terence, Nkengasong John N
Projet RETRO-CI, Abidjan, Côte d'Ivoire.
AIDS. 2003 Jul;17 Suppl 3:S17-22. doi: 10.1097/00002030-200317003-00003.
To describe changes in immune activation and reconstitution markers among HIV-1-infected patients receiving antiretroviral therapy (ART) in Abidjan, Côte d'Ivoire.
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.
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.
Our results suggest that HAART can be successfully used in African populations with elevated baseline immune activation markers.
描述在科特迪瓦阿比让接受抗逆转录病毒治疗（ART）的HIV-1感染患者中免疫激活和重建标志物的变化。
在1998年11月至2001年2月期间，我们分析了52例患者免疫激活和重建标志物的变化。病毒学应答良好者（n = 26）定义为那些血浆病毒载量（VL）被抑制并维持在检测限以下至少12个月的患者。病毒学应答不佳者（n = 26）定义为在开始ART后6个月和12个月时VL可检测到的患者。
在26例病毒学应答良好者中，20例（77%）接受了高效抗逆转录病毒治疗（HAART），而病毒学应答不佳者中只有1例（4%）接受了HAART。在26例应答良好者中，CD38+CD8+ T细胞的基线中位数水平升高，但在治疗6个月时（P < 0.001）和12个月时（P < 0.001）显著下降。HLA-DR+CD8+ T细胞的中位数水平在治疗6个月时（P < 0.001）和12个月时（P < 0.001）也从基线下降。CD62L+CD4+ T细胞水平在治疗的6个月和12个月期间稳步上升，并达到了在HIV阴性献血者中观察到的水平（P = 0.07）。在26例应答不佳者中，CD38+CD8+ T细胞的中位数水平在治疗12个月时显著下降（P = 0.006），但高于献血者中的水平（P = 0.005）。HLA-DR+CD8+ T细胞水平在治疗12个月时显著下降（P < 0.001）。CD62L+CD4+水平随时间下降。
我们的结果表明，HAART可成功用于基线免疫激活标志物升高的非洲人群。
