AIDSWEEKLY Plus, Monday, 3 March 1997
Daniel J. DeNoon, Senior Editor
Now that long-term suppression of HIV appears possible, the central question for treated patients is whether their full immune function can be restored.
Longitudinal studies appear best suited to answer this question. A pilot study by a French research team provides intriguing baseline data and a glimpse into the future.
G. Gorochov of Pitie-Salpetriere Hospital, Paris, and colleagues studied T-cell repertoires in three groups of patients: four long-term non-progressors, three typical progressors, and eight additional patients studied before and during combination antiretroviral therapy.
They reported their preliminary findings at the Fourth Conference on Retroviruses and Opportunistic Infections, held January 22-26, 1997, in Washington, D.C.
"All patients studied present with drastic alterations of the CD8 repertoire which appear to be strongly oligoclonal and are usually stable over years," they wrote in their presentation abstract. "This repertoire skewing seemed independent of the clinical status or the plasma viral load."
The patients' CD4 repertoires were relatively conserved but tended to diminish in patients with clinical disease progression. The only long-term non-progressor with a high viral load also had a diminished CD4 repertoire.
Six months' treatment with combination antiretroviral therapy including a protease inhibitor appeared to improve CD4 repertoires, but CD8 repertoires remained skewed.
"On the basis of the abnormalities that we report, further longitudinal studies will tell us whether a complete restoration of the diversity of the immune system can be expected in certain treated patients," Gorochov et al. concluded.
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