Naïve/Effector CD4 T cell ratio as a useful predictive marker of immune reconstitution in late presenter HIV patients: A multicenter study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 20 06 2019
accepted: 03 11 2019
entrez: 24 12 2019
pubmed: 24 12 2019
medline: 24 3 2020
Statut: epublish

Résumé

A significant proportion of HIV-infected patients experiencing a late diagnosis highlights the need to define immunological protocols able to help the clinicians in identifying patients at higher risk for immunological failure. The aim of the study was to evaluate the feasibility of easy cytometric tests in defining the effect of antiretroviral treatment (cART) on immunological homeostasis and in identifying predictive markers of early immune recovery. Chronic HIV infected patients (n = 202) were enrolled in a prospective multicentric study, and their immunological profile was studied before (w0) and after 24 weeks (w24) of antiretroviral treatment (cART) using a standardized flow cytometric panel. Based on CD4 T cell count before treatment, patients were divided in late (LP: CD4 <350/mmc), intermediate (IP: 350/mmc<CD4<500/mmc) and early (EP: CD4 >500/mmc) presenters. In all groups, cART introduction increased CD4 and CD4/CD8 T cell ratio, naïve T cell (CD4 and CD8) and CD127-expressing CD4 T cells. In parallel, cART significantly reduced effector memory T cells (CD4 and CD8) and T cell activation (CD38+CD8 and CD95+CD4 T cells). Moreover, the frequency of Naïve and Effector CD4 T cells before treatment correlated with several immune parameters key associated with the pathogenesis of HIV, thus mirroring the health of immune system. Interestingly, we identified the Naïve/Effector CD4 T cell ratio (N/EM) at w0 as a marker able to predict early immune recovery. Specifically, in LP, N/EM ratio was significantly higher in immunological responder patients (CD4>500/mmc at w24) when compared to immunological non responder (CD4 T cells <500/mmc at w24). Finally, a multivariate analysis indicates that after 24w patients with N/EM ratio higher than 1.86 at w0 recovered 96 CD4 T cells more than those with N/EM ratio lower than 0.46. Altogether, our data define an easy protocol able to define reliable immunological markers useful for the characterization of immune profile in viremic HIV patients and identify the naïve/effector CD4 T cell ratio as a new tool able to predict an early immune reconstitution potential.

Identifiants

pubmed: 31869342
doi: 10.1371/journal.pone.0225415
pii: PONE-D-19-17484
pmc: PMC6927630
doi:

Substances chimiques

Anti-HIV Agents 0

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0225415

Déclaration de conflit d'intérêts

The support of Becton Dickinson does not alter our adherence to PLOS ONE policies on sharing data and materials.

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Auteurs

Veronica Bordoni (V)

INMI L. Spallanzani IRCCS, Rome, Italy.

Bruno Brando (B)

Blood Transfusion Center, Legnano General Hospital, Legnano, Italy.

Pierluca Piselli (P)

INMI L. Spallanzani IRCCS, Rome, Italy.

Olindo Forini (O)

INMI L. Spallanzani IRCCS, Rome, Italy.

Federico Enrico Perna (FE)

Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Umberto Atripaldi (U)

Department of Clinical Biochemistry, Ospedali dei Colli, Naples, Italy.

Sara Carputo (S)

Department of Clinical Biochemistry, Ospedali dei Colli, Naples, Italy.

Federica Garziano (F)

Department of Clinical Biochemistry, Ospedali dei Colli, Naples, Italy.

Elisabetta Trento (E)

San Gallicano Dermatological Institute IRCCS, Rome, Italy.

Giovanna D'Agosto (G)

San Gallicano Dermatological Institute IRCCS, Rome, Italy.

Alessandra Latini (A)

San Gallicano Dermatological Institute IRCCS, Rome, Italy.

Manuela Colafigli (M)

San Gallicano Dermatological Institute IRCCS, Rome, Italy.

Antonio Cristaudo (A)

San Gallicano Dermatological Institute IRCCS, Rome, Italy.

Alessandra Sacchi (A)

INMI L. Spallanzani IRCCS, Rome, Italy.

Massimo Andreoni (M)

Clinical Infectious Diseases, Department of System Medicine, University of Rome "Tor Vergata", Rome, Italy.

Gabriella De Carli (G)

Clinical Department, INMI L Spallanzani IRCCS, Rome, Italy.

Nicoletta Orchi (N)

Clinical Department, INMI L Spallanzani IRCCS, Rome, Italy.

Sandro Grelli (S)

Clinical Microbiology and Virology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.

Arianna Gatti (A)

Blood Transfusion Center, Legnano General Hospital, Legnano, Italy.

Carlotta Cerva (C)

General Pathology and Immunology, Department of Biology, University of Rome "Tor Vergata", Rome, Italy.

Antonella Minutolo (A)

General Pathology and Immunology, Department of Biology, University of Rome "Tor Vergata", Rome, Italy.

Marina Potestà (M)

General Pathology and Immunology, Department of Biology, University of Rome "Tor Vergata", Rome, Italy.

Maria Luisa Di Martino (ML)

Laboratorio di Allergologia e Diagnostica dell'HIV della S.C. Medicina Interna, Azienda Ospedaliero Universitaria Cagliari, Cagliari, Italy.

Francesco Ortu (F)

Dipartimento di Medicina, Azienda Ospedaliero Universitaria Cagliari, Cagliari, Cagliari, Italy.

Paola Selva (P)

Laboratorio Unico Metropolitano (LUM), Azienda USL, Bologna, Italy.

Laura Del Pup (L)

UOC Anatomia Patologica, Azienda ULSS2 Marca Trevigiana, Treviso, Italy.

Irene Guarnori (I)

Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy.

Patrizia Lorenzini (P)

Clinical Department, INMI L Spallanzani IRCCS, Rome, Italy.

Giusy Capuano (G)

Becton Dickinson Italia, Milan, Italy.

Andrea Antinori (A)

Clinical Department, INMI L Spallanzani IRCCS, Rome, Italy.

Chiara Agrati (C)

INMI L. Spallanzani IRCCS, Rome, Italy.

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