1070. A normal CD4/CD8 ratio, a particular differentiation pattern and an over expression of CD25 characterize patients with an exceptional TCD4+ recovery during effective HAART
Session: Poster Abstract Session: HIV: Basic Science and Pathogenesis
Friday, October 9, 2015
Room: Poster Hall
Posters
  • 2015. Poster ID Week V.7.pdf (1.3 MB)
  • Background:   Clinical outcome of HIV infected patients relies on the recovery of  CD4+ T cells after HAART. However this immune recovery is variable and difficult to predict. Here we present a cohort of patients with undetectable viral load and a follow up of 48 months of HAART who reached CD4+ T cell counts >1000 cels/mm3 (Hypers) and compare them to those who reached between 350 and 999 CD4+ T cels/mm3 (concordants). Their demographic data, immune recovery kinetics, and T CD4+ subsets phenotype were analysed. 

    Methods: Retrospective data were obtained from the charts of 447 undetectable patients on their first ARV regimen and a follow up of 48 months at the INCMSZ HIV cohort. 28 Hypers (6%) and 354 concordants (79%) were identified.  For this analysis, only 21 Hypers and 25 Concordants matched by sex, age and T CD4+ nadir were selected. The following subsets were analyzed by Flow cytometry on whole blood: naïve T-cells, central memory T-cells, effector memory and terminally differentiated. Immune activation was assessed with CD38 and HLADR, and senescent cells were identified as CD57+CD28neg T cells. Also, we measured the expression of CD25 (IL-2R). Finally, we used the expression of CD31 as a marker of recent thymic emigrants (RTE).

    Results: No differences were found in clinical and demographic characteristics between groups. CD4/CD8 ratio after 6 weeks post-HAART was higher for Hypers (0.61 vs 0.39, p< 0.01) and this difference was maintained over time. The speed of CD4+ T-cell recovery during the first two years of HAART was higher in the Hyper group (17.83 vs 8.75, p< 0,05). Hypers had a higher proportion of CD4+ naïve T-cells (37.6 vs 24.8, p< 0.05), and a low proportion of CD4+ EM T Cells (27.9 vs 39.4, p< 0.05), with simillar results found in CD8+ T Cells. The expression of CD25 in CD4+ CD45RA+ T Cells of hypers was higher (3.11 vs 1.26, p< 0.001). No differences were found in activation, immunesenescense nor CD31+ T Cells.

    Conclusion: T cell recovery of Hypers occurs very early and with a higher speed suggesting a different re-distribution of T cells. Hypers present a normal CD4/CD8 ratio at 6 months after HAART and a pattern of differentiation suggesting that Concordants have still an accelerated differentiation in spite of having undetectable viral loads.

    José Miguel Rodriguez-Castañon, MD, María Graciela Leal Gutiérrez, MD, Ayleen Cárdenas-Ochoa, MCC, Andrea Carolina Tello Mercado, MD, Juan José Romero-Carvajal, MD, Juan Sierra-Madero, MD, Luis Soto-Ramírez, MD and Santiago Perez-Patrigeon, MD, PhD, Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Disclosures:

    J. M. Rodriguez-Castañon, None

    M. G. Leal Gutiérrez, None

    A. Cárdenas-Ochoa, None

    A. C. Tello Mercado, None

    J. J. Romero-Carvajal, None

    J. Sierra-Madero, Abbvie: Speaker , Speaker honorarium
    Roche: Speaker , Speaker honorarium
    Janssen: Speaker , Speaker honorarium
    MSD: Speaker , Speaker honorarium
    ViiV: Speaker , Speaker honorarium
    Stendhal: Speaker , Speaker honorarium

    L. Soto-Ramírez, Abbvie: Speaker , Speaker honorarium
    Roche: Speaker , Speaker honorarium
    Janssen: Speaker , Speaker honorarium
    MSD: Speaker , Speaker honorarium
    ViiV: Speaker , Speaker honorarium
    Stendhal: Speaker , Speaker honorarium

    S. Perez-Patrigeon, Abbvie: Speaker , Speaker honorarium
    Roche: Speaker , Speaker honorarium
    Janssen: Speaker , Speaker honorarium
    MSD: Speaker , Speaker honorarium
    ViiV: Speaker , Speaker honorarium
    Stendhal: Speaker , Speaker honorarium

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.