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. 2003 Jul 15;188(2):209-18.
doi: 10.1086/376509. Epub 2003 Jul 1.

Correlates of immune activation marker changes in human immunodeficiency virus (HIV)-seropositive and high-risk HIV-seronegative women who use illicit drugs

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Correlates of immune activation marker changes in human immunodeficiency virus (HIV)-seropositive and high-risk HIV-seronegative women who use illicit drugs

Alan Landay et al. J Infect Dis. .

Abstract

The majority of natural history studies of human immunodeficiency virus (HIV) infection have immune and viral parameters in men. Data demonstrating that women have lower HIV-1 RNA levels than men at the same CD4 cell counts have raised the question of immunologic differences in HIV-seropositive women. This study describes levels and changes in phenotypic markers of immune maturity, function, and activation in the CD4 and CD8 cell subsets in HIV-seropositive and high-risk HIV-seronegative women. Our primary hypothesis was that activation levels would be significantly higher among illicit drug users. However, results showed that HIV-1 RNA level was the strongest predictor of marker level and that both HIV-1 RNA level and CD4 cell count were independently associated with CD4 activation, but illicit drug use was not. In summary, this study demonstrated that immune activation was a significant pathogenic feature in women and that activation was driven by HIV infection and not illicit drug use.

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Figures

Figure 1
Figure 1
Scatter plots with nonlinear smooth curves of baseline percentage of HLADR+/CD38+ expressed in CD4 (dashed line) and CD8 (solid line) T cells over the range of baseline human immunodeficiency virus type 1 (HIV-1) RNA levels for 176 HIV-seropositive women. Curves were fitted with the S-PLUS lowess function (MathSoft). Open circles represent individual data points for CD4, and closed triangles represent data points for CD8. Vertical lines divide HIV-1 RNA levels into groups corresponding to those in table 2.
Figure 2
Figure 2
Scatter plots for percentage of CD4 T cell activation level vs. CD4 cell count in human immunodeficiency virus (HIV)–seronegative (left) and HIV-seropositive (center) women and for percentage of CD4 T cell activation level vs. HIV RNA level (right) for drug users (○) and non–drug users (▲). Regression lines from models including CD4 cell count or HIV-1 RNA level, drug use, and their interactions are shown for HIV-seropositive women; solid lines, drug users; dashed lines, non–drug users.

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