gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Stable percentages of CD4+ T-cells and lower levels of soluble CD25 in elite controllers, but not intermediate controllers of HIV-1 replication

Konstante prozentuale CD4+ T-Zellen und niedrigere Spiegel an löslichem CD25 in Elite Kontrollern im Vergleich zu intermediate Kontrollern

Meeting Abstract

  • C. Lehmann - University of Cologne, Internal Medicine, Cologne, Germany
  • S. Trapp - University of Cologne, Institute of Virology, Cologne, Germany
  • F. Schweitzer - University of Cologne, Institute of Virology, Cologne, Germany
  • P. Hartmann - University of Cologne, Internal Medicine, Cologne, Germany
  • R. Kaiser - University of Cologne, Institute of Virology, Cologne, Germany
  • G. Fätkenheuer - University of Cologne, Internal Medicine, Cologne, Germany
  • German NaViC-Studygroup

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocHIV 10-4

DOI: 10.3205/10kit011, URN: urn:nbn:de:0183-10kit0118

Veröffentlicht: 2. Juni 2010

© 2010 Lehmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: The objective was to determine whether there is a non-detrimental level of plasma viremia (pVL) in Long-Term Nonprogressors (LTNP) and to explore immune correlates of protection such as, HIV-encoding defective nef-variants or a characteristic cytokine profile against disease progression.

Methods: 31 patients from a database of more than 6000 patients met the definition of Elite Controller (EC, n=18) or Intermediate Controller (IC, n=13). We defined 2 groups. EC: CD4+ T-cells ≥500/uL, pVL < 50 copies/mL. IC: CD4+ T-cells ≥500/uL, pVL 50–2000 copies/mL. Analyses of nef-modifications of HIV by nef sequencing and chemokine/cytokine profile in plasma using the 25plex Luminex technology were additionally performed.

Results: Median time since HIV-diagnosis was 11 years [2–17] and 3.5 years [2–10.5] for EC and IC, respectively. At baseline, median CD4+ T-cells did not significantly differ between groups. CD4+ T-cell counts and percentage were 880/µl and 39% [576-1056, 34-41%] vs. 762/µl and 37% [562–983, 31–43%] in EC and IC, respectively. We observed a significant decrease of CD4+ T-cell percentage (38% [29–41] vs. 31% [28–34]; p=0.0002) in IC – but not in EC – over time. Nef sequencing showed in both groups mainly mutations in regions important for MHCI down regulation and/or retention, possibly resulting in a more efficient peptide presentation to CD8+ T-cell. Moreover, we found in plasma of EC significant lower levels of soluble (s) CD25 (p<0.05) as well as slightly lower levels of IL12 and CXCL9 (MIG).

Conclusions: In ECs, the percentage of CD4+ T-cell remains stable with long-term follow-up. The small, but significant, decrease in the percentage of CD4+ T-cells in IC seems to be related to HIV replication. Lower levels of sCD25 in EC might be explained by an inhibition of CD25 shedding from CD4+ T- cells which could be responsible for a better T cell proliferation. We conclude that there is no “safe” level of HIV replication.