211-T. Substantial Rate of Lymphoproliferative Response to HIV-1-Specific Antigens after Prolonged Suppression of Viral Replication with HAART

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Session 41 Poster Session
CD4 T-Helper Responses to HIV
Session Time: 4:30-6:30 pm
Room 4E-F

211-T.

Substantial Rate of Lymphoproliferative Response to HIV-1-Specific Antigens after Prolonged Suppression of Viral Replication with HAART
G. Breton*¹, D. S. Algara², X. Duval¹, P. Longuet¹, J. L. Ecobichon¹, C. Leport¹, and J. L. Vildé¹
¹Bichat Hosp.; and ²Pasteur Inst., Paris, France

Background: Specific lymphoproliferative response (LPR) to HIV-1 antigens is usually undetectable in HIV-infected patients with HAART. However, it is possible that such response has not been observed because of too short a duration of HAART.
Methods: We realized a transversal study of LPR to HIV-1 p24 and gp120 antigens in chronically HIV-1-infected patients. Patients were receiving continuous HAART with prolonged inhibition of viral replication (< 200 copies/mL) for more than 24 months and with an increase of more than 100 CD4+ cells/µL.
Results: 28 patients were studied. The median age was 42.6 years. At HAART initiation, 12 patients were at CDC stage C3, the mean nadir CD4+ cells was 155/µL (1-478/µL) and the mean HIV-1 viral load was 135,000 copies/mL (3000-540,000 copies/mL). The mean duration of HAART was 39.3 months (26-52 months). The mean time of viral load suppression (< 200 copies/mL) was 34.7 months (25-47 months). The mean increase of CD4+ cells was 384/µL (122-724/µL). Positive LPR to recall antigens (staphylococcal enterotoxin, tuberculin, candidine) was observed with PBMC and CD4+ cells in more than 85% of the patients. Positive LPR to p24 antigen was detected in 16/28 patients (57%): 13/27 patients (48%) with PBMC and 10/28 patients (36%) with CD4+ cells. Positive LPR to gp120 antigen was detected in 2/28 patients (7%) and 6/28 patients (21%) with PBMC and CD4+ cells respectively. 17 patients (61%) had a positive response whatever the HIV antigen (p24 or gp120) and the type of cells analysed (PBMC or CD4+). There were no statistically significant differences between these responder and other (non-responder) patients according to age, sex, CDC stage, CD4+ cells nadir, initial viral load, duration of HAART, duration of viral replication inhibition, increase of CD4+ cells, and proportion of naïve and memory CD4+ or CD8+ cells after HAART.
Conclusion: HIV-1-specific response was observed in 61% of chronically HIV-infected patients after a long term (3 years) of viral load suppression by HAART even in absence of treatment interruption. Thus, HIV-1-specific immune restoration could occur after a long time of efficient HAART.