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Clinical Trial
. 2012;7(7):e39356.
doi: 10.1371/journal.pone.0039356. Epub 2012 Jul 17.

T cell subsets in HIV infected patients after successful combination antiretroviral therapy: impact on survival after 12 years

Frederikke Falkencrone Rönsholt  1 , Sisse Rye Ostrowski, Terese Lea Katzenstein, Henrik Ullum, Jan Gerstoft
Affiliations
Clinical Trial

T cell subsets in HIV infected patients after successful combination antiretroviral therapy: impact on survival after 12 years

Frederikke Falkencrone Rönsholt et al. PLoS One. 2012.

Abstract

Objectives: Immune activation is decreased by combination antiretroviral therapy (cART) in patients infected with human immunodeficiency virus (HIV), but residual activation remains and has been proposed as a cause of premature aging and death, but data are lacking. We analyzed the relationship between T-cell subsets after 18 months of cART and overall survival during 12 years of follow up.

Methods: A cohort of 101 HIV infected patients who had undetectable plasma HIV after starting cART was included in 1997-1998. T cell subsets were analyzed by flowcytometry after 18 months of cART. Relation to survival was calculated using Kaplan-Meier curves and multiple Cox regression.

Results: Seventeen patients died during the observation period. The leading causes of death were non-AIDS cancer and cardiovascular disease. Higher levels of CD8 memory T cells (CD8+,CD45RO+,CD45RA-) showed a significant beneficiary effect on survival, HR of 0.95 (95% confidence interval 0.91-0.99, P = 0.016) when adjusted for age, nadir CD4 count, CD4 count, and AIDS and hepatitis C status. T cell activation was not associated with increased risk of death.

Conclusions: Larger and longitudinal studies are needed to accurately establish prognostic factors, but overall results seem to suggest that prognostic information exists within the CD8 compartment.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Kaplan-Meier plots.
The observation period (days) is from 18 months (+/−6 months) after initiation of cART till death or 01/01/2010. The dotted line depicts the highest 50th percentile and the full line depicts the lowest 50th percentile. Analysis of survival linked to T cell subset are made with proportions of CD4+ and CD8+ cells respectively. Analysis using concentrations instead of proportions yielded similar results. Subsets were defined as naïve CD4/8(CD45RA+, CD62+), memory CD4/8 (CD45RA-, CD45R0+) and activated CD4 (HLA-DR+), and activated CD8 (HLA-DR+, CD38+).
See this image and copyright information in PMC

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