Aug 21, 2012

Disease Progression in HIV-1-Infected Viremic Controllers

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Katherine C GrovesAine McKnight


The mechanism of CD4 T-cell decline in HIV-1 infection is unclear, but the association with plasma viral RNA load suggests viral replication is involved. Indeed, viremic controller patients with low viral RNA loads typically maintain high CD4 T-cell counts. Within a local cohort of 86 viremic controllers, we identify a subgroup (18 "discord controllers") with low CD4 T-cell counts that present clinical uncertainty. The underlying mechanism accounting for CD4 T-cell decline in the face of low or undetectable plasma (RNA) viral load remains unresolved. The objective of this study was to investigate the viral and host immune system dynamics in discord controllers by measuring cellular HIV-1 DNA load, T-cell populations, and T-cell activation markers. We compared discord controllers (viral RNA load <2000 copies/mL, <450 CD4 T-cells/mm) with typical controllers (viral RNA load <2000 copies/mL, >450 CD4 T-cells/mm) and progressors (viral RNA load >10,000 copies/mL, <450 CD4 T-cells/mm). We quantified CD4/CD8 naive/central memory/effector memory subsets (CD45RA/RO ± CD62L), activation levels (CD38HLA-DR), and HIV-1 DNA load. Discord controllers resembled progressors showing high viral DNA load, depletion of naive CD4 T-cells, and high...Continue Reading

Mentioned in this Paper

Immune System
DNA, Viral
Virus Titer
Virus Replication
CD45RA Antigens
HIV Infections
CD4 Count Determination Procedure
T-Cell Activation
CD38 protein, human

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