Historique
Périodique
Increased levels of activated subsets of CD4 T cells add to the prognostic value of low CD4 T cells counts in a cohort of HIV-infected drug users
(L'augmentation des taux de sous-groupes de CD4 T activés apporte un complément d'information sur le pronostic donné par une numération basse des CD4 T chez les usagers de drogues contaminés par le VIH.)
Auteur(s) :
CARBONE J. ;
GIL, J. ;
BENITO, J. M. ;
NAVARRO, J. ;
MUNOZ-FERNANDEZ, A. ;
BARTOLOME, J. ;
ZABAY, J. M. ;
LOPEZ, F. ;
FERNANDEZ-CRUZ, E.
Année
2000
Page(s) :
2823-2829
Langue(s) :
Anglais
Refs biblio. :
42
Domaine :
Drogues illicites / Illicit drugs
Discipline :
MAL (Maladies infectieuses / Infectious diseases)
Note générale :
AIDS, 2000, 14, (18), 2823-2829
Résumé :
FRANÇAIS :
Le but de l'étude est d'identifier des sous groupes de lymphocytes CD4 T pouvant prédire le développement du sida et de déterminer si l'augmentation de ces marqueurs peut fournir des informations indépendantes sur le pronostic établi par numération des CD4 T et les taux plasmatiques de ARN-VIH-1. Dans le cadre d'une étude prospective, 85 UDVIs séropositifs au VIH ont été suivis pendant 37 +/- 13 mois. L'analyse phénotypiques des sous groupes de lymphocytes CD4 et CD8 T, quantifiés par cytométrie à trois couleur, montre que parmi les lymphocytes CD4 T, le sous groupe CD4+CD38+DR+ est un marqueur de l'évolution de la maladie vers le sida. L'augmentation de ces cellules reflète le degré d'activation des CD4 T, donc la progression de l'atteinte des cellules immunitaires corrélée au risque de progression vers le sida.
ENGLISH :
objective: To identify subsets of CD4 T lymphocytes that can predict the development of AIDS and to assess whether increased levels of these cellular markers could provide additional independent prognostic information to the CD4 T cell count and plasma HIV-1-RNA levels. Design and methods: In a prospective study, a cohort of 85 HIV-positive intravenous drug users [clinical categories of the CDC classification A (n=48) and B (n=37)] were followed for a period of 37 + 13 months. Memory and activated CD4 and CD8 T cells were quantitated by three-colour flow cytometry at baseline and expressed as a percentage of total CD4 and CD8 lymphocytes. Clinical evaluations were performed at 6 month intervals. The relationships between these lymphocyte subsets and progression to AIDS were studied using Kaplan-Meier plots and proportional hazards regression models. Results: After adjustment for the level of CD4 T cells and plasma HIV-1-RNA levels, the elevation in the subset CD4+CD38+DR+ was the marker within the functionally distinct subsets of CD4 T lymphocytes with additional prognostic value in bivariate Cox regression models. In multivariate models, increased percentages of CD4+CD38+DR+ T cells provided the strongest independent prognostic information for progression to AIDS (relative hazard, 1.07; P<0.0001). Conclusion: Our results suggest that high levels of CD4+CD38+HLA-DR+ T cells reflect the increasing degree of CD4 T cell activation during the progression of HIV infection, and could be used together with the CD4 T cell and HIV-RNA levels to evaluate more accurately the progressive cellular immune impairment associated with the risk of progression to AIDS. (Author' s abstract)
Le but de l'étude est d'identifier des sous groupes de lymphocytes CD4 T pouvant prédire le développement du sida et de déterminer si l'augmentation de ces marqueurs peut fournir des informations indépendantes sur le pronostic établi par numération des CD4 T et les taux plasmatiques de ARN-VIH-1. Dans le cadre d'une étude prospective, 85 UDVIs séropositifs au VIH ont été suivis pendant 37 +/- 13 mois. L'analyse phénotypiques des sous groupes de lymphocytes CD4 et CD8 T, quantifiés par cytométrie à trois couleur, montre que parmi les lymphocytes CD4 T, le sous groupe CD4+CD38+DR+ est un marqueur de l'évolution de la maladie vers le sida. L'augmentation de ces cellules reflète le degré d'activation des CD4 T, donc la progression de l'atteinte des cellules immunitaires corrélée au risque de progression vers le sida.
ENGLISH :
objective: To identify subsets of CD4 T lymphocytes that can predict the development of AIDS and to assess whether increased levels of these cellular markers could provide additional independent prognostic information to the CD4 T cell count and plasma HIV-1-RNA levels. Design and methods: In a prospective study, a cohort of 85 HIV-positive intravenous drug users [clinical categories of the CDC classification A (n=48) and B (n=37)] were followed for a period of 37 + 13 months. Memory and activated CD4 and CD8 T cells were quantitated by three-colour flow cytometry at baseline and expressed as a percentage of total CD4 and CD8 lymphocytes. Clinical evaluations were performed at 6 month intervals. The relationships between these lymphocyte subsets and progression to AIDS were studied using Kaplan-Meier plots and proportional hazards regression models. Results: After adjustment for the level of CD4 T cells and plasma HIV-1-RNA levels, the elevation in the subset CD4+CD38+DR+ was the marker within the functionally distinct subsets of CD4 T lymphocytes with additional prognostic value in bivariate Cox regression models. In multivariate models, increased percentages of CD4+CD38+DR+ T cells provided the strongest independent prognostic information for progression to AIDS (relative hazard, 1.07; P<0.0001). Conclusion: Our results suggest that high levels of CD4+CD38+HLA-DR+ T cells reflect the increasing degree of CD4 T cell activation during the progression of HIV infection, and could be used together with the CD4 T cell and HIV-RNA levels to evaluate more accurately the progressive cellular immune impairment associated with the risk of progression to AIDS. (Author' s abstract)
Affiliation :
Dpt Immunology, Univ. General Hospital Gregorio Maranon, Complutense Univ., Madrid
Espagne. Spain.
Espagne. Spain.