No abstract

Measures of immune outcomes in youth who initiate combination antiretroviral therapy (cART) early in HIV infection are limited. Design Adolescent Trials Network 061 examined changes over 48 weeks of cART in T cell subsets and markers of T cell and macrophage activation in subjects with pre-therapy CD4>350. All subjects had optimal viral suppression from weeks 24 through 48. Methods Subjects (n=48) initiated cART with tenofovir/emtricitabine plus ritonavir-boosted atazanavir. Data were collected at baseline and weeks 12, 24, and 48. Trends were compared to uninfected controls. Results Significant increases over 48 weeks were noted in all CD4 populations including total, naïve, central memory (CM), and effector memory RO (EM RO) and effector memory RA (EM RA) while numbers of CM and EMRO CD8 cells declined significantly. By week 48, CD4 naïve cells were similar to controls while CM CD4 cells remained significantly lower and EM RO and EM RA subsets were significantly higher. CD38 and HLA DR expression, both individually and when co-expressed, decreased over 48 weeks of cART on CD8 cells but remained significantly higher than controls at week 48. In contrast, markers of macrophage activation measured by sCD14 and sCD163 in plasma did not change with cART and were significantly higher than controls. Conclusion In youth initiating early cART, CD4 cell reconstitution is robust with decreases in CD8 cells. However CD8 T cell and macrophage activation persists at higher levels than uninfected controls.

No abstract

No abstract