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Naïve CD4 Cell Counts Significantly Decay and High HIV RNA Levels Contribute to Immunological Progression in Long-term Non-progressors Infected with HIV by Blood Products: a Cohort Study

Overview
Journal BMC Immunol
Publisher Biomed Central
Date 2021 Jun 4
PMID 34082709
Citations 2
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Abstract

Background: Some long-term non-progressors (LTNPs) have decreasing CD4 T cell counts and progress to AIDS. Exploring which subsets of CD4 T cell decreasing and the determinants associated with the decay in these patients will improve disease progression surveillance and provide further understanding of HIV pathogenesis.

Methods: Twenty-five LTNPs infected with HIV by blood products were classified as decreased (DG) if their CD4 cell count dropped to < 400 cells/μL during follow-up or as non-decreased (non-DG) if their CD4 cell count was ≥400 cells/μL. Laboratory and clinical assessments were conducted at 6 consecutive visits to identify DG characteristics.

Results: The LTNPs were infected with HIV for 12 (IQR: 11.5-14) years, and 23 were classified as the B' subtype. Six individuals lost LTNP status 14.5 (IQR: 12.5-17.5) years after infection (DG), and the CD4 T cell count decreased to 237 (IQR: 213-320) cells/μL at the latest visit. The naïve CD4 T cell count decrease was greater than that of memory CD4 T cells [- 128 (IQR: - 196, - 107) vs - 64 (IQR: - 182, - 25) cells/μL)]. Nineteen individuals retained LTNP status (non-DG). At enrolment, the viral load (VL) level (p = 0.03) and CD8CD38 percentage (p = 0.03) were higher in DG than non-DG individuals. During follow-up, viral load and CD8CD38 percentage were significantly increased and negatively associated with CD4 cell count [(r = - 0.529, p = 0.008), (r = - 0.476, p = 0.019), respectively]. However, the CD8CD28 percentage and B cell count dropped in DG and were positively correlated with CD4 T cell count [(r = 0.448, p = 0.028), (r = 0.785, p < 0.001)].

Conclusion: Immunological progression was mainly characterized by the decrease of naïve CD4 T cell in LTNPs infected with HIV by blood products and it may be associated with high HIV RNA levels.

Citing Articles

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Immune Responses to HBV Vaccine in People Living with HIV (PLWHs) Who Achieved Successful Treatment: A Prospective Cohort Study.

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