560. Immune Recovery of Acute HIV Treated Patients is Characterized by an Increase in Immune Senescence
Session: Poster Abstract Session: HIV: Antiretroviral Therapy
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • Poster IDWeek2018 v3.pdf (753.0 kB)
  • Background:

    ARV treatment (ART) administered during acute HIV-infection presents several immunological benefits leading to a better CD4+ T cell recovery and a diminished HIV reservoir.

    Methods:

    Patients with acute HIV-infection, enrolled in the VIHIA cohort, had blood samples taken at diagnosis and at 2, 6 and 12 months after ART initiation. Flow-cytometry analysis was performed in fresh whole blood. Naïve-(Nv), central memory (CM), effector memory (EM) and terminally differentiated- T-cells (TMRA), as well as activation markers were defined using CD3, CD4, CD8, CD45RA, CCR7, CD38, CD31 and HLA-DR markers. CD28 and CD57 were used to identify immunosenescent cells. Fox-P3, CD       25, CD127 and CD45RA were used to identify Regulatory T cells (Treg) and their subsets. To assess changes over time, Wilcoxon matched-pairs signed rank test was used for each value between baseline and months 2 and 12 independently.

    Results:

    4 patients were diagnosed at Fiebig stage II; 5 patients at Fiebig stage III, 24 patients at stage IV and 5 patients in stage V. All patients received treatment within the first 24 hours of HIV diagnosis. Only 13 patients had flow-cytometry data at baseline and 1 year of follow-up. All subjects were MSM with a mean age of 32 y.o. Mean CD4+ T cell count was 439 cells/uL and mean viral load was 1.2 million copies/ml (23379-10x106 copies/ml) at baseline. The change in T cell differentiation patterns at 0 and 12 months is shown in Figure 1. Activation markers decreased in all studied subsets at 2 months and furthermore at 12 months. Total T-regs increased from 5.1% to 7.8% at one year of follow-up (Figure 2). Immunosenescence markers increased steadily throughout the study in all T cell subsets, being statistically significant in the total T cell CD8 population at 12 months of follow-up (Figure 3) unrelated to Fiebig stage.

    Conclusion:

    It has been hypothesized that early ART decreases T-cell immunosenescence, however in our cohort despite treatment during acute HIV, we observed that at 1 year follow-up immunosenescence markers increased despite a decrease in immune activation and a recovery of T cell subsets.

     

    Rocio Jaramillo-Jante, MD1, Antonio Camiro-Zúñiga, MD, MSC1, Marco Najera-Avila, MD1, Ayleen Cárdenas Ochoa, MCC1, Christian Hernández-León, MD2, Juan Luis Mosqueda-Gómez, MD3, Samuel Navarro-Alarez, MD4, Daniel Scott-Algara, MD, PhD5, Luis E. Soto-Ramirez, MD1, Brenda Crabtree-Ramirez, MD1, Pablo Francisco Belaunzaran-Zamudio, MD, PHD1, Juan G. Sierra-Madero, MD6 and Santiago Perez-Patrigeon, MD, PhD1, (1)Infectious Diseases, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico, (2)Centros Ambulatorios para la Prevención y Atención en SIDA e Infecciones de Transmisión Sexual, Puebla, Mexico, (3)Centros Ambulatorios para la Prevención y Atención en sida e Infecciones de Transmisión Sexual, León, Mexico, (4)Infectious Diseases, Hospital General de Tijuana, Tijuana, Mexico, (5)Institut Pasteur, Paris, France, (6)Infectious Diseases, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico

    Disclosures:

    R. Jaramillo-Jante, None

    A. Camiro-Zúñiga, None

    M. Najera-Avila, None

    A. Cárdenas Ochoa, None

    C. Hernández-León, None

    J. L. Mosqueda-Gómez, None

    S. Navarro-Alarez, None

    D. Scott-Algara, None

    L. E. Soto-Ramirez, None

    B. Crabtree-Ramirez, None

    P. F. Belaunzaran-Zamudio, None

    J. G. Sierra-Madero, None

    S. Perez-Patrigeon, None

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