1 Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet2 Section of Diagnostic Sciences, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet3 unknown4 Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet5 Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet
OBJECTIVE:: Residual immune activation and skewed T cell maturation may contribute to excess comorbidity and mortality in successfully treated HIV infected patients and long term effects of combination antiretroviral therapy (cART) on immune reconstitution remain a debated issue. We investigated quantitative T cell reconstitution and activation and its association to residual viraemia in patients with 12 years of viraemic suppression. DESIGN:: Blood samples collected cross-sectionally from 71 HIV infected patients with cART induced viraemic suppression through 12 years were compared to samples from 16 healthy controls. METHODS:: Several different subsets of naïve, memory and activated T cells were analyzed in fresh whole blood by 6-color flowcytometry and ultra sensitive quantification of HIV RNA was performed. RESULTS:: HIV-infected patients (HIV+) had lower absolute and relative CD4 T cell counts and higher absolute and relative CD8 T cell counts than controls. HIV+ had lower concentrations of naïve CD4 cells than controls, but proportions were similar. HIV+ had higher concentrations of CD8+ T cells than controls in all of the examined subsets, but only a higher proportion of CD8+ cells in the intermediately differentiated and activated subsets. Residual viraemia did not correlate to proportions of naïve CD4, CD4 RTEs, or activated CD8 T cells. CONCLUSIONS:: This study demonstrated some degree of T cell imbalance even after 12 years of successful cART. Large longitudinal studies are needed to establish whether or not these discrete changes have clinical relevance.