Residual viremia in patients on antiretroviral therapy incorporating nevirapine is not associated with the gag-specific cellular immune response

J Med Virol. 2014 Jun;86(6):1087-92. doi: 10.1002/jmv.23743. Epub 2013 Sep 23.

Abstract

To determine whether residual plasma viremia in HIV(+) patients on nevirapine-including antiretroviral therapy (ART) is related to anti-HIV cellular immune responses, a case-control study was conducted comparing residual viremia in patients with detectable and undetectable Gag-specific T-cell responses. Gag-specific responses were measured by IFN-γ ELISpot. Residual viremia was determined at two consecutive hospital visits by an ultra-sensitive technique with a detection limit of 2 copies/ml. Median residual viremia was not different in patients with a positive Gag-specific ELISpot (n = 25) compared to those with a negative Gag-specific ELISpot (n = 30, P = 0.91). Ten of 25 (40%) patients with consistent detectable residual viremia and 4 of 12 (33%) patients with consistently undetectable residual viremia had a positive Gag-specific ELISpot. Undetectable residual viremia was associated with the duration of ART including nevirapine (P < 0.05), but not with the Gag-specific ELISpot response. Gag-specific CTL in patients on ART therefore appear to have no impact on the virus-producing cells that are responsible for residual viremia during ART.

Keywords: CTL; HIV; antiretroviral therapy; viremia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Retroviral Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / methods
  • Case-Control Studies
  • Enzyme-Linked Immunospot Assay
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology*
  • HIV Infections / virology
  • Humans
  • Immunity, Cellular*
  • Interferon-gamma / metabolism
  • Male
  • Middle Aged
  • Nevirapine / therapeutic use*
  • T-Lymphocytes / immunology
  • Viremia*
  • gag Gene Products, Human Immunodeficiency Virus / immunology*

Substances

  • Anti-Retroviral Agents
  • gag Gene Products, Human Immunodeficiency Virus
  • Interferon-gamma
  • Nevirapine