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.
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