Immunologic Profile of Lymphocytes of HIV+ Patients

QUIROGA F; BIBINI M; ZALA C; LOSSO M; FAINBOIM L; SALOMON H; SARACCO M

Punta del Este, Uruguay

Congreso; Vto Congreso Latinoamericano de Inmunología; 1999

ALAI

Objective: to describe the immunologic profile in peripheral blood lymphocytes from HIV+ patients treated with different therapies. Mat. y Met.: 26 HIV+ patients were studied; 9 treated with aniretroviral therapy (ARV) plus Hidroxyurea (HU), 8 with ARV plus protease inhibitor (IP), 9 with CD4 count below 200 célls/mm3 (a group that includes treatment  naive patients and treated with double or try therapy), a control HIV(-) group and a group of patients with hematological malignancies (SMP: Mieloproliferative Chronic Syndrome) treated with HU. Blood was stained with monoclonal antibodies for T lymphocytes (TL), helper lymphocytes (CD4+), cytotoxic lymphocytes (CD8), activation markers CD25, CD38, HLA-DR and naive/memory markers CD45RA/CD45RO and analyzed by flow cytometry. Results: HIV+ patients treated with ARV+IP showed a higher lymphocyte count and CD4+ TL count than patients treated with ARV+HU, but a lower percentage of TL and absolute count of CD4/CD45RA lymphocytes. There were no differences on the other activation markers studied. Comparing HIV+ group with CD4<200cells/mm3 vs. ARV+HU there were a higher number of CD8+ cells and a lower 4/8 rate in patients with CD4<200cells/mm3. CD25 and HLA-DR didn´t differ between these groups. CD38 marker was higher on CD8+ TL in CD4<200cells/mm3 patients. CD45RA expression was higher on CD4+ and CD8+ TL in ARV+HU treated patients, while CD45RO was similar on CD8+ TL from both groups and higher on CD4+TL from ARV+HU treated patients. SMP patients presented TL with a normal helper/suppressor ratio, although they didn´t show CD4 counts or activation pattern higher than CD4<200cells/mm3 patients. We evaluated the immunologic profile of patients treated with ARV plus IL-2, and they show a CD4+ TL count higher than other groups, although they show lower CD8+TL count. 4/8 ratio was higher, but didn´t reach normal values. CD8/CD38 TL percentage was higher than normal values for all HIV+ groups. CD8/CD45RO coexpression was similar in HIV+ patients treated with ARV+IP and with ARV+IL-2, but was higher in those patients that received ARV+HU treatment. Conclusion: We observed in HIV+ patients an activated phenotype, regardless of treatment. Although they present a low CD4+ TL count, patients treated with ARV+HU conserve this activated profile. IL2 treatment would help immune recovery, augmenting CD4+ TL count and 4/8 ratio.