Restoration of CD4 T-cell responses to cytomegalovirus is short-lived in severely immunodeficient HIV-infected patients responding to highly active antiretroviral therapy

N.M. Keane, Patricia Price, S. Lee, Coral-Ann Almeida, Shelley Stone, I. James, Martyn French

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objectives To define the level of pathogen-specific immune reconstitution persisting over 3 to 5 years of highly active antiretroviral therapy (HAART) in HIV-infected patients who began therapy with CD4 T-cell counts below 50 cells/muL.Methods Cytomegalovirus (CMV)-specific T-cell responses were analysed in adult HfV-1-infected patients with nadir CD4 T-cell counts below 50 cells/mul before HAART. CMV-specific CD4 T-cell responses were measured by interferon-gamma enzyme-linked immunospot assay (ELISpot assay), lymphoproliferation and interferon-gamma levels in cell culture supernatants.Results CD4 T-cell responses to CMV were low in untreated patients and remained low during the first year on HAART, but increased progressively to levels similar to those found in HIV-seronegative CMV-seropositive controls at 3 years. Responses then declined markedly and at 5 years were lower than controls. This could not be explained by changes in CD4 or CD8 T-cell counts or plasma HIV RNA levels. Interferon-gamma and interleukin-5 responses to a mitogen were maintained or elevated.Conclusions CMV-specific CD4 T-cell responses were found to decline after 3-5 years on HAART and may provide inadequate long-term protection against CMV disease in patients who are severely immunodeficient prior to treatment.
Original languageEnglish
Pages (from-to)407-414
JournalHIV Medicine
Volume5
Issue number6
DOIs
Publication statusPublished - 2004

Fingerprint Dive into the research topics of 'Restoration of CD4 T-cell responses to cytomegalovirus is short-lived in severely immunodeficient HIV-infected patients responding to highly active antiretroviral therapy'. Together they form a unique fingerprint.

Cite this