Older HIV-infected patients on antiretroviral therapy have B-cell expansion and attenuated CD4 cell increases with immune activation reduction
| Autor: | Roy M. Matining, Barry H. Gross, Susan A. Fiscus, Isaac R. Francis, Alan L. Landay, Robert C. Kalayjian, Richard B. Pollard, John Spritzler, Michael M. Lederman |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
CD4-Positive T-Lymphocytes Male Aging Adolescent Anti-HIV Agents animal diseases Immunology HIV Infections chemical and pharmacologic phenomena CD8-Positive T-Lymphocytes Article Young Adult Humans Receptors Tumor Necrosis Factor Type II Immunology and Allergy Medicine Hiv infected patients Prospective Studies B cell B-Lymphocytes business.industry Age Factors virus diseases HLA-DR Antigens Middle Aged biochemical phenomena metabolism and nutrition ADP-ribosyl Cyclase 1 Antiretroviral therapy Virology Infectious Diseases medicine.anatomical_structure Cd4 cell bacteria Drug Therapy Combination Female business Immune activation |
| Zdroj: | AIDS. 27:1563-1571 |
| ISSN: | 0269-9370 |
| DOI: | 10.1097/qad.0b013e32835fabc2 |
| Popis: | The contribution of immune activation to accelerated HIV-disease progression in older individuals has not been delineated.Prospective multicenter cohort of older (≥45 years) and younger (18-30 years) HIV-infected adults initiating 192 weeks of antiretroviral therapy (ART). Longitudinal models of CD4 cell restoration examined associations with age-group, thymic volume, immune activation, and viral load.Forty-five older and 45 younger adults (median age 50 and 26 years, respectively) were studied. Older patients had fewer naive CD4 cells (P0.001) and higher HLA-DR/CD38 expression on CD4 (P=0.05) and CD8 cells (P=0.07) than younger patients at any time on ART. The rate of naive and total CD4 cell increase was similar between age groups, but older patients had a faster mean rate of B-cell increase (by +0.7 cells/week; P=0.01), to higher counts than healthy controls after 192 weeks (P=0.003). Naive CD4 increases from baseline were associated with immune activation reductions (as declines from baseline of %CD8 cells expressing HLA-DR/CD38; P0.0001), but these increases were attenuated in older patients, or in those with small thymuses. A 15% reduction in activation was associated with naive gains of 29.9 and 6.2 cells/μl in younger, versus older patients, or with gains of 25.7, 23.4, and 2.1 cells/μl in patients with the largest, intermediate, and smallest thymuses, respectively (P0.01 for interactions between activation reduction and age-group or thymic volume).Older patients had significant B-cell expansion, higher levels of immune activation markers, and significantly attenuated naive CD4 cell gains associated with activation reduction. |
| Databáze: | OpenAIRE |
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