H-4052. Changes in T- Cell Subsets of HIV Infected Long-Term Non Progressors (LTNP)
Session: Poster Session: HIV: Basic Science and Pathogenesis
Tuesday, October 28, 2008: 12:00 AM
Room: Hall C
Background: Only a small minority of HIV infected patients control virus replication spontaneously and remain stable over long periods of time in the absence of therapy . Within LTNP subjects with complete virologic control (elite controllers, EC) and with low viral loads (intermediate controllers, IC) can be differentiated. Little is known about the long-term changes of T-cell subsets in EC versus IC. Methods: In this multicenter study, patients were recruited from a German network of clinical HIV centers caring for more than 6000 patients. 2 groups were defined: 1. EC (n=8): HIV plasma viral load (pVL) 500/uL. 2. IC (n=24): pVL 50-2000 cps /mL, CD4+ T-cells >500/uL. Min. follow-up for all patients was 1 yr, and at least 3 samples of CD4+ T-cells and pVL had to be available for analysis. Exclusion criteria were pVL increase to a confirmed value of >50 cps/mL (group 1) and of >2000 cps/mL (group 2) or initiation with ART or IL-2. Results: Median duration of HIV diagnosis in EC was 16.50 yrs. [IQR] [3.0-21.25] and 4.5 [2.0- 11.0] in IC. At baseline median CD4+T-cells did not significantly differ between groups: EC 952/uL, 37.2% [578-1083, 31.05-43%] vs. IC 802/uL, 37.4% [632-996, 31-41%]. While absolute numbers of CD4+ and CD8+ T-cells did not differ between EC and IC over time, we observed a significant decrease of CD4+ T-cell percentage in IC but not in EC. The calculated median annual CD4+ changes were 0% [0-0.2] in EC and -0.6% [0.03-1] in IC (p<0.05). CD8+ T-cell percentages increased (42 [33-52] vs. 48 [37-60] and CD4/CD8 ratios (0.9 [0.6-1.3] vs. 0.6[0.5-0.9]) decreased during the observation period in IC but not in EC. Conclusions: Although absolute numbers of CD4+ and CD8+ T-cells remain stable over long periods of time in both EC and IC, subtle but significant changes of CD4+ and CD8+ T-cell percentages can be observed in IC but not in EC.
Schlomo Staszewski1, Stefan Mauss, MD2, Clara Lehmann3, Dirk Meyer-Olson, MD4, Gerd Fatkenheuer5, Jan van Lunzen5, Jurgen Rockstroh6, Pavel Khaykin5, Pia Hartmann, MD PhD5 and  C. Lehmann, None., (1)JW Goethe University Hospital, (2)Arzt für Innere Medizin, (3)University, Cologne, Germany, (4)Partners AIDS Res. Ctr., Mass Gen. Hosp./Div. of AIDS, Harvard Med. Sch., Charlestown, MA, (5)University, (6)Univ of Bonn, Venusburg, Germany

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