Reduced Central Memory CD4+ T Cells and Increased T-Cell Activation Characterise Treatment-Naive Patients Newly Diagnosed at Late Stage of HIV Infection

doi:10.1155/2012/314849

AIDS Res Treat. 2012; 2012: 314849.

Published online 2011 October 27. doi: 10.1155/2012/314849

PMCID: PMC3205670

Reduced Central Memory CD4+ T Cells and Increased T-Cell Activation Characterise Treatment-Naive Patients Newly Diagnosed at Late Stage of HIV Infection

Francesca Bai,¹^* Camilla Tincati,¹ Esther Merlini,¹ Carlotta Pacioni,¹ Elisabetta Sinigaglia,² Giovanni Carpani,² Antonella d'Arminio Monforte,¹ and Giulia Marchetti¹

¹Department of Medicine, Surgery and Dentistry, Clinic of Infectious Diseases and Tropical Medicine, S. Paolo Hospital, University of Milan, via A. di Rudinì, 8-20142 Milan, Italy

²Blood Transfusion Centre, San Paolo Hospital, Milan, Italy

*Francesca Bai: Email: francesca.bai/at/yahoo.it

Academic Editor: Francesca Ceccherini-Silberstein

Received May 23, 2011; Revised August 5, 2011; Accepted August 23, 2011.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract

Objectives. We investigated immune phenotypes of HIV+ patients who present late, considering late presenters (LPs, CD4+ < 350/μL and/or AIDS), advanced HIV disease (AHD, CD4+ < 200/μL and/or AIDS), and AIDS presenters (AIDS-defining condition at presentation, independently from CD4+). Methods. Patients newly diagnosed with HIV at our clinic between 2007–2011 were enrolled. Mann-Whitney/Chi-squared tests and logistic regression were used for statistics. Results. 275 patients were newly diagnosed with HIV between January/2007–March/2011. 130 (47%) were LPs, 79 (29%) showed AHD, and 49 (18%) were AIDS presenters. LP, AHD, and AIDS presenters were older and more frequently heterosexuals. Higher CD8+%, lower CD127+CD4+%, higher CD95+CD8+%, CD38+CD8+%, and CD45R0+CD38+CD8+% characterized LP/AHD/AIDS presentation. In multivariate analysis, older age, heterosexuality, higher CD8+%, and lower CD127+CD4+% were confirmed associated with LP/AHD. Lower CD4+ and higher CD38+CD8+% resulted independently associated with AIDS presentation. Conclusions. CD127 downregulation and immune activation characterize HIV+ patients presenting late and would be studied as additional markers of late presentation.

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