Improvement in cell-mediated immune function during potent anti-human immunodeficiency virus therapy with ritonavir plus saquinavir

J Infect Dis. 1998 Apr;177(4):898-904. doi: 10.1086/515244.

Abstract

Inhibiting human immunodeficiency virus (HIV) replication with potent antiretroviral therapy may result in improved immune function, and this may lead to favorable outcomes, independent of changes in CD4+ lymphocyte count. The effect of combination protease inhibitor therapy (ritonavir plus saquinavir) on functional measures of cell-mediated immunity in 41 HIV-infected patients from one center of a multicenter trial was investigated. After 24 weeks, median plasma virus load decreased from 4.74 log10 copies/mL to below the detection limit of the assay (2.30 log10), and mean CD4+ lymphocyte count increased from 284 cells/microL to 413 cells/microL. Proliferative responses to phytohemagglutinin developed in 21 of 34 patients in whom responses were absent at baseline. Increases were observed in interleukin-2, -12, and -10 production and in the expression of CD28 on CD8+ lymphocytes. Initiation of potent anti-HIV therapy results in a degree of immune restoration, suggesting that HIV-induced immune suppression is a dynamic and potentially reversible process.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • CD28 Antigens / immunology
  • CD28 Antigens / metabolism
  • CD4 Lymphocyte Count
  • CD8-Positive T-Lymphocytes / immunology
  • Cell Division
  • Drug Therapy, Combination
  • Flow Cytometry
  • HIV / isolation & purification
  • HIV Infections / drug therapy*
  • HIV Infections / immunology*
  • HIV Protease Inhibitors / administration & dosage
  • HIV Protease Inhibitors / therapeutic use*
  • Humans
  • Immunity, Cellular*
  • Interleukin-10 / metabolism
  • Interleukin-12 / metabolism
  • Interleukin-2 / metabolism
  • Leukocytes, Mononuclear / cytology
  • Leukocytes, Mononuclear / immunology
  • Phytohemagglutinins / immunology
  • RNA, Viral / isolation & purification
  • Ritonavir / administration & dosage
  • Ritonavir / therapeutic use*
  • Saquinavir / administration & dosage
  • Saquinavir / therapeutic use*
  • Viral Load

Substances

  • CD28 Antigens
  • HIV Protease Inhibitors
  • Interleukin-2
  • Phytohemagglutinins
  • RNA, Viral
  • Interleukin-10
  • Interleukin-12
  • Saquinavir
  • Ritonavir