Dynamics of Immune Reconstitution and Activation Markers in HIV plus Treatment-Naive Patients Treated with Raltegravir, Tenofovir Disoproxil Fumarate and Emtricitabine

作者：Funderburg Nicholas T^*; Andrade Adriana; Chan Ellen S; Rosenkranz Susan L; Lu Darlene; Clagett Brian; Pilch Cooper Heather A; Rodriguez Benigno; Feinberg Judith; Daar Eric; Mellors John; Kuritzkes Daniel; Jacobson Jeffrey M; Lederman Michael M

来源：PLos One, 2013, 8(12): e83514.

DOI：10.1371/journal.pone.0083514

Background: The dynamics of CD4+ T cell reconstitution and changes in immune activation and inflammation in HIV-1 disease following initiation of antiretroviral therapy (ART) are incompletely defined and their underlying mechanisms poorly understood. %26lt;br%26gt;Methods: Thirty-nine treatment-naive patients were treated with raltegravir, tenofovir DF and emtricitabine. Immunologic and inflammatory indices were examined in persons with sustained virologic control during 48 weeks of therapy. %26lt;br%26gt;Results: Initiation of ART increased CD4+ T cell numbers and decreased activation and cell cycle entry among CD4+ and CD8+ T cell subsets, and attenuated markers of coagulation (D-dimer levels) and inflammation (IL-6 and TNFr1). These indices decayed at different rates and almost all remained elevated above levels measured in HIV-seronegatives through 48 weeks of viral control. Greater first and second phase CD4+ T cell restoration was related to lower T cell activation and cell cycling at baseline, to their decay with treatment, and to baseline levels of selected inflammatory indices, but less so to their changes on therapy. %26lt;br%26gt;Conclusions: ART initiation results in dynamic changes in viral replication, T cell restoration, and indices of immune activation, inflammation, and coagulation. These findings suggest that determinants of T cell activation/cycling and inflammation/coagulation may have distinguishable impact on immune homeostasis.

• 出版日期2013-12-18