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Immune recovery of acute HIV treated patients is characterized by an increase in immune senescence.
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Reported by Jules Levin
IDWeek 2018, October 3-7, 2018, San Francisco
Maria del Rocio Jaramillo-Jante1, MD; Antonio Camiro-Zuniga1, MD, MSC; Marco A. Najera Avila1; Ayleen Cairdenas Ochoa1, MSC; MD; Christian Hernandez-Leon2, MD; Juan L. Mosqueda-Gomez3, MD; Samuel
Navarro-Alarez4; Daniel Scoc-Algara5, MD, PhD; Luis E. Soto RamiÅLrez1, MD; Brenda Crabtree-Ramirez1, MD; Francisco BelaunzaraÅLn-Zamudio1 MD; Juan G. Sierra Madero1, MD; Santiago Perez-Patrigeon1, MD, PhD.
1 - Departamento de infectologia, Instuto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico. 2 - CAPASITS Puebla, Puebla de Zaragoza, Mexico. 3
- CAPASITS Leon, Guanajuato, Mexico. 4 - Hospital General de Tijuana,BC, Mexico. 5 - Institut Pasteur, Paris, France
poster pdf attached
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Maria del Rocio Jaramillo-Jante1, MD; Antonio Camiro-Zuniga1, MD, MSC; Marco A. Najera Avila1; Ayleen Cairdenas Ochoa1, MSC; MD; Christian Hernandez-Leon2, MD; Juan L. Mosqueda-Gomez3, MD; Samuel Navarro-Alarez4; Daniel Scoc-Algara5, MD, PhD; Luis E. Soto RamiÅLrez1, MD; Brenda Crabtree-Ramirez1, MD; Francisco BelaunzaraÅLn-Zamudio1 MD; Juan G. Sierra Madero1, MD; Santiago Perez-Patrigeon1, MD, PhD.
1 - Departamento de infectologia, Instuto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico. 2 - CAPASITS Puebla, Puebla de Zaragoza, Mexico. 3 - CAPASITS Leon, Guanajuato, Mexico. 4 - Hospital General de Tijuana,BC, Mexico. 5 - Institut Pasteur, Paris, France
program abstract
Background:
ARV treatment (ART) administered during acute HIV-infection presents several immunological benefits leading to a better CD4+ T cell recovery and a diminished HIV reservoir.
Methods:
Patients with acute HIV-infection, enrolled in the VIHIA cohort, had blood samples taken at diagnosis and at 2, 6 and 12 months after ART initiation. Flow-cytometry analysis was performed in fresh whole blood. Naïve-(Nv), central memory (CM), effector memory (EM) and terminally differentiated- T-cells (TMRA), as well as activation markers were defined using CD3, CD4, CD8, CD45RA, CCR7, CD38, CD31 and HLA-DR markers. CD28 and CD57 were used to identify immunosenescent cells. Fox-P3, CD 25, CD127 and CD45RA were used to identify Regulatory T cells (Treg) and their subsets. To assess changes over time, Wilcoxon matched-pairs signed rank test was used for each value between baseline and months 2 and 12 independently.
Results:
4 patients were diagnosed at Fiebig stage II; 5 patients at Fiebig stage III, 24 patients at stage IV and 5 patients in stage V. All patients received treatment within the first 24 hours of HIV diagnosis. Only 13 patients had flow-cytometry data at baseline and 1 year of follow-up. All subjects were MSM with a mean age of 32 y.o. Mean CD4+ T cell count was 439 cells/uL and mean viral load was 1.2 million copies/ml (23379-10x106 copies/ml) at baseline. The change in T cell differentiation patterns at 0 and 12 months is shown in Figure 1. Activation markers decreased in all studied subsets at 2 months and furthermore at 12 months. Total T-regs increased from 5.1% to 7.8% at one year of follow-up (Figure 2). Immunosenescence markers increased steadily throughout the study in all T cell subsets, being statistically significant in the total T cell CD8 population at 12 months of follow-up (Figure 3) unrelated to Fiebig stage.
Conclusion:
It has been hypothesized that early ART decreases T-cell immunosenescence, however in our cohort despite treatment during acute HIV, we observed that at 1 year follow-up immunosenescence markers increased despite a decrease in immune activation and a recovery of T cell subsets.
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