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Baseline Naive CD4＋ T-cell Level Predicting Immune Reconstitution in Treated HIV-infected Late Presenters

Chinese Medical Journal 2016年第22期129卷 2683-2690页

作者： Fu-Ping Guo Yi-Jia Li Zhi-Feng Qiu Wei Lv Yang Han Jing Xie Yan-Ling Li Xiao-Jing Song Shan-Shan Du vikram mehraj Tai-Sheng Li Jean-Pierre Routy Department of Infectious Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China Division of Hematology Research Institute and Chronic Viral Illness Service McGill University Montreal Quebec Canada

Background：Among HlV-infected patients initiating antiretroviral therapy （ART）,early changes in CD4＋ T-cell subsets are well ***,HIV-infected late presenters initiating treatment present with a suboptimal CD4＋ T-cell reconstitution and remain at a higher risk for AIDS and non-AIDS ***,factors associated with CD4＋ T-cell reconstitution need to be determined in this population,which will allow designing effective immunotherapeutic ***：Thirty-one adult patients with baseline CD4＋ T-cell count 〈350 cells/mm^3 exhibiting viral suppression after ART initiation were followed in the HIV/AIDS research center of Peking Union Medical College Hospital in Beijing,China,from October 2002 to September *** in T-cell subsets and associated determinants were ***：Median baseline CD4＋ T-cell count was 70 cells/*** found a biphasic reconstitution ofT-cell subsets and immune activation：a rapid change during the first 6 months followed by a more gradual change over the subsequent 8 *** CD4＋ T-cell count 〉200 cells/ mm3 in comparison to CD4＋ T-cell count ≤200 cells/mm3 was associated with more complete immune Reconstitution （77.8% vs.27.3% respectively;P =0.017） and normalized CD4/CD8 *** showed that the baseline percentage of naive CD4＋ T-cell was a predictive marker for complete immune reconstitution （area under receiver operating characteristic curve 0.907）,and 12.4% as cutoffvalue had a sensitivity of 84.6% and a specificity of 88.2%.Conclusions：Baseline naive CD4＋ T-cell percentage may serve as a predictive marker for optimal immune reconstitution during long-term *** study findings suggest that increasing thymic output should represent an avenue to improve patients who are diagnosed late in the course of infection.

关键词： Antiretroviral Therapy HIV Immune Activation Naive CD4+ T-cell Thymic Function

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