Important note: Information in this article was accurate in December 2000. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, December 18, 2000
Prepared by AIDS Weekly editors from staff and other reports
The researchers conclude that long-term restoration of immune cells in such patients is dependent, therefore, on thymic potential.
Michael M. Lederman, of Case Western Reserve University School of Medicine in Ohio, along with colleagues at a number of other academic institutions as well as Glaxo Wellcome, Inc., studied lymphocyte phenotypes of 71 HIV positive patients receiving abacavir and a protease inhibitor (PI). The patients had not received antiretroviral therapy prior to being enrolled in the 48-week study. The researchers' objective was "to characterize early and later indices of cellular restoration ... and to identify predictors of CD4 cell increases" in the patients, they stated in the December 1, 2000, issue of the journal AIDS.
Numbers of naive and memory CD4 and B cells increased in the first four weeks after initiating therapy with abacavir + PI. Overall, CD8 cell counts were stable during this initial period; numbers of naive CD8 cells increased, Lederman et al. found, while memory CD8 cells decreased, for no net change.
After four weeks (second stage), the researchers observed continuing increase in all CD4 cells and in CD8 cells, but numbers of total CD8 and memory CD8 cells declined.
"The numbers of CD4 cells that expressed CD28 increased from a median of 308x10 & & 6 & & /l at baseline to 477x10 & & 6 & & /l at week 48," Lederman et al. reported. "Higher baseline plasma HIV-1 RNA levels predicted the magnitude of early CD4 (r=0.35; P= 0.01), memory CD4 (r=0.38; P=0.001), and CD28 CD4 cell (r=0.29; P=0.01) restoration but was not related to second phase changes."
In the second phase of the study, greater increase in naive CD4 cells could be predicted by younger age (r=-0.31; P = 0.03), the research team reported ("Cellular restoration in HIV infected persons treated with abacavir and a protease inhibitor: age inversely predicts naive CD4 cell count increase," AIDS, December 1, 2000;14(17):2635-2642).
Lederman and co-authors drew two conclusions from their study:
Co-authors on this AIDS paper included researchers at Dreams du Jour Inc., Point Harbor, North Carolina; Glaxo-Wellcome Inc., Research Triangle Park, North Carolina; University of Pittsburgh, Pennsylvania; Covance Inc., Indianapolis, Indiana; Yale University, New Haven, Connecticut; Vanderbilt University, Nashville, Tennessee; University of California San Diego, California; Kansas City AIDS Research Consortium, Missouri; Carolinas Medical Center, Charlotte, North Carolina; and Rush Presbyterian Medical Center, Chicago, Illinois.
A search of the NewsRx.com online database using the terms "HIV" and "antiretroviral" yielded 1,217 additional articles.
This article was prepared by AIDS Weekly editors from staff and other reports.
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