Bini, T

Carpani, G

d'Arminio Monforte, A

Marchetti, GC

Merlini, E

Sinigaglia, E

English

PubMed

E Merlini

E Sinigaglia

G Carpani

T Bini

A d'Arminio Monforte

GC Marchetti

Crossref

Journal of the International AIDS Society

Efficient immune reconstitution in HIV+ naïve patients (pts) starting a first lopinavir/ritonavir-containing regimen with low CD4 counts

Springer - Publisher Connector

POSTER PRESENTATION Open Access
Efficient immune reconstitution in HIV+ naïve
patients (pts) starting a first lopinavir/ritonavir-
containing regimen with low CD4 counts
E Merlini1*, E Sinigaglia2, G Carpani2, T Bini1, A d’Arminio Monforte1, GC Marchetti3
From Tenth International Congress on Drug Therapy in HIV Infection
Glasgow, UK. 7-11 November 2010
Purpose of the study
Investigate immune restoration profile, T-cell activation
and microbial translocation in HIV+ naïve pts starting a
first LPV/r-containing regimen with low CD4.
Methods
40 HIV+ antiretroviral-naive pts starting a first tenofo-
vir/emtricitabine + LPV/r-containing ART with CD4
<350 (20 Late Presenters —LPs, CD4 <100/µL and 20
Non-Late Presenters —NLPs, CD4, 200—350/µL) were
followed for 12 months (T12). Microbial translocation
(MT) by plasma lipopolysaccharide (LPS) and sCD14
(LAL assay and ELISA), CD38+CD8, CD45R0+38+CD8,
CD127+CD4/CD8 (flow cytometry), and plasma IL-7
(ELISA) were tested at T0 and T12. T0 and T12 differ-
ences were analyzed by Mann Whitney U test.
Summary of results
At T12, all 40 HIV+ pts displayed a significant CD4 rise,
HIV viremia reduction (p=0.0006; p<0.0001, respectively)
and a decrease in activated CD38+CD8 (p<0.0001), with a
trend to an increase in CD127+CD8 (p=0.07). By T12,
both LPs and NLPs displayed a significant CD4 increase
(LPs: p=0.0001; NLPs: p=0.001), with LPs maintaining sig-
nificantly lower CD4 at T12 (p=0.0001). At T12, NLPs
and LPs displayed a significant reduction in CD38+CD8+
(p=0.009; p=0.018, respectively); only NLPs displayed a
decreasing trend in terminally-differentiated CD45R0
+CD38+CD8 (p=0.077). Compared to LPs, NLPs featured
higher CD127+CD4 proportions at all timepoints (T0,
p=0.0001; T12, p=0.001), with a significant increase in
CD127+CD8 by T12 (p=0.012), whereas no changes were
seen in LPs. NLPs also displayed a significant rise in circu-
lating IL-7 (p=0.049), whereas LPs showed a decreasing
trend (p=0.074). At T0, NLPs showed higher levels of MT
markers (LPS: p=0.01; sCD14: p=0.007). By T12, only
NLPs displayed a significant reduction in LPS (p=0.022)
and in sCD14 (p=0.005), whereas no changes were shown
in LPs.
Conclusions
In HIV+ antiretroviral-naive pts with low CD4, LPV/
r-containing regimens resulted in adequate immune
reconstitution and restoration of the IL-7/IL-7R system.
Interestingly, microbial translocation was efficiently con-
trolled only in patients with less advanced HIV infection.
However, LPV/r-based treatment resulted in a significant
reduction of peripheral T-cell activation also in patients
with late presentation. Given that T-cell activation is pre-
dictive of disease progression, our data advocate the effi-
cacy of LPV/r regimens in broad immune reconstitution
in HIV-infected pts with advanced infection.
Author details
1“San Paolo” Hospital, Clinic of Infectious Diseases, Milan, Italy. 2“San Paolo”
Hospital, Blood Transfusion Center, Milan, Italy. 3“San Paolo Hospital”, Clinic
of Infectious and Tropical Diseases, Milan, Italy.
Published: 8 November 2010
doi:10.1186/1758-2652-13-S4-P17
Cite this article as: Merlini et al.: Efficient immune reconstitution in HIV+
naïve patients (pts) starting a first lopinavir/ritonavir-containing
regimen with low CD4 counts. Journal of the International AIDS Society
2010 13(Suppl 4):P17.
1“San Paolo” Hospital, Clinic of Infectious Diseases, Milan, Italy
Full list of author information is available at the end of the article
Merlini et al. Journal of the International AIDS Society 2010, 13(Suppl 4):P17
http://www.jiasociety.org/content/13/S4/P17
© 2010 Merlini et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


file:///data/remote/core/dit/data/Springer-OA/pdf/efd/aHR0cDovL2xpbmsuc3ByaW5nZXIuY29tLzEwLjExODYvMTc1OC0yNjUyLTEzLVM0LVAxNy5wZGY=.pdf

Efficient immune reconstitution in HIV+ naïve patients (pts) starting a first lopinavir/ritonavir-containing regimen with low CD4 counts

Abstract

Similar works

Full text

Available Versions

Crossref

Springer - Publisher Connector

Springer - Publisher Connector