Apoptosis of naive CD4+ T-cells from HIV-infected patients with poor immune response to HAART is enhanced in vitro by steroid - 24/08/11
for the Groupe d'Etudes Niçois Polyvalent en Infectiologie (GENPI)
Abstract |
Objective. Because the absence of immune restoration in HIV-infected patients efficiently treated by highly active antiretroviral therapy (HAART) may be due to excessive immune activation, we prospectively studied the effect of hydrocortisone on T-cell apoptosis in a cohort of patients with satisfactory virologic response.
Methods. Apoptosis of T-cell subsets including naıve CD45RA+CD4+ T-cells was determined at baseline and at months 1 and 3 after initiation of HAART. A satisfactory immune response was defined as an increase >100/μL CD4+ T-cells at month 3 compared to baseline.
Results. Twenty out of 63 patients showed undetectable viral load at month 3, among whom eight exhibited a satisfactory immune response. Down-regulation spontaneous CD4+ T-cell apoptosis was significant in the group of patients with a satisfactory immune response compared to the other patients. However, hydrocortisone up-regulated apoptosis of naıve CD4+ CD45RA+ T-cells, specifically in group of patients with poor immune response, whatever the time point considered: percentage of apoptotic CD4 T-cells was 16±16% without hydrocortisone and 22±22% with hydrocortisone at month 1, and respectively, 10±9 and 17±15% at month 3 (P<0.05). Hydrocortisone had no impact on CD8+ T-cell apoptosis, whatever the considered group.
Conclusion. Our results suggest to not use steroid therapy as adjuvant immunotherapy in patients with less than optimal immunologic response to HAART.
Le texte complet de cet article est disponible en PDF.Keywords : HAART, Immune reconstitution, Apoptosis, Steroid
Plan
Vol 49 - N° 3
P. 216-221 - octobre 2004 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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