Immunologic responses associated with 12 weeks of combination antiretroviral therapy consisting of zidovudine, lamivudine, and ritonavir: results of AIDS Clinical Trials Group Protocol 315

J Infect Dis. 1998 Jul;178(1):70-9. doi: 10.1086/515591.

Abstract

Human immunodeficiency virus (HIV)-1 infection is associated with progressive cell-mediated immune deficiency and abnormal immune activation. Although highly active antiretroviral therapy regimens can increase circulating CD4 T lymphocyte counts and decrease the risk of opportunistic complications, the effects of these treatments on immune reconstitution are not well understood. In 44 persons with moderately advanced HIV-1 infection, after 12 weeks of treatment with zidovudine, lamivudine, and ritonavir, plasma HIV-1 RNA fell a median of 2.3 logs (P < .0001). Circulating numbers of naive and memory CD4 T lymphocytes (P < .001), naive CD8 T lymphocytes (P < .004), and B lymphocytes (P < .001) increased. Improved lymphocyte proliferation to certain antigens and a tendency to improvement in delayed-type hypersensitivity also were seen. Dysregulated immune activation was partially corrected by this regimen; however, the perturbed expression of T cell receptor V regions in the CD4 and CD8 T lymphocyte populations was not significantly affected. Ongoing studies will ascertain if longer durations of virus suppression will permit more complete immune restoration.

Publication types

  • Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antigens / immunology
  • B-Lymphocytes / immunology
  • CD4 Lymphocyte Count
  • Drug Therapy, Combination
  • Female
  • HIV Antigens / immunology
  • HIV Infections / drug therapy*
  • HIV Infections / immunology*
  • HIV Infections / virology
  • HIV Protease Inhibitors / therapeutic use
  • HIV-1 / genetics
  • HIV-1 / immunology*
  • HIV-1 / physiology
  • Humans
  • Hypersensitivity, Delayed
  • Lamivudine / therapeutic use
  • Lymphocyte Activation
  • Lymphocyte Count
  • Male
  • Middle Aged
  • RNA, Viral / blood
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Ritonavir / therapeutic use
  • T-Lymphocyte Subsets / immunology
  • Time Factors
  • Zidovudine / therapeutic use

Substances

  • Anti-HIV Agents
  • Antigens
  • HIV Antigens
  • HIV Protease Inhibitors
  • RNA, Viral
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • Zidovudine
  • Ritonavir