High T-cell immune activation and immune exhaustion among individuals with suboptimal CD4 recovery after 4 years of antiretroviral therapy in an African cohort

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dc.contributor.authorNakanjako, Damalie
dc.contributor.authorSsewanyana, Isaac
dc.contributor.authorMayanja-Kizza, Harriet
dc.contributor.authorKiragga, Agnes
dc.contributor.authorManabe, Yukari C.
dc.contributor.authorNabatanzi, Rose
dc.contributor.authorKamya, Moses R.
dc.contributor.authorCao, Huyen
dc.date.accessioned2022-05-20T06:08:58Z
dc.date.available2022-05-20T06:08:58Z
dc.date.issued2011
dc.description.abstractAntiretroviral therapy (ART) partially corrects immune dysfunction associated with HIV infection. The levels of T-cell immune activation and exhaustion after long-term, suppressive ART and their correlation with CD4 T-cell count reconstitution among ART-treated patients in African cohorts have not been extensively evaluated.T-cell activation (CD38+HLA-DR+) and immune exhaustion (PD-1+) were measured in a prospective cohort of patients initiated on ART; 128 patient samples were evaluated and subcategorized by CD4 reconstitution after long-term suppressive treatment: Suboptimal [median CD4 count increase 129 (-43-199) cells/μl], N = 34 ], optimal [282 (200-415) cells/μl, N = 64] and super-optimal [528 (416-878) cells/μl, N = 30].Both CD4+ and CD8 T-cell activation was significantly higher among suboptimal CD4 T-cell responders compared to super-optimal responders. In a multivariate model, CD4+CD38+HLADR+ T-cells were associated with suboptimal CD4 reconstitution [AOR, 5.7 (95% CI, 1.4-23, P = 0.014)]. T-cell exhaustion (CD4+PD1+ and CD8+PD1+) was higher among suboptimal relative to optimal (P < 0.001) and super-optimal responders (P < 0.001). T-cell exhaustion was significantly associated with suboptimal responders [AOR, 1.5 (95%CI, 1.1-2.1), P = 0.022].T-cell activation and exhaustion persist among HIV-infected patients despite long-term, sustained HIV-RNA viral suppression. These immune abnormalities were associated with suboptimal CD4 reconstitution and their regulation may modify immune recovery among suboptimal responders to ART.en_US
dc.identifier.citationNakanjako, D., Ssewanyana, I., Mayanja-Kizza, H., Kiragga, A., Colebunders, R., Manabe, Y. C., ... & Cao, H. (2011). High T-cell immune activation and immune exhaustion among individuals with suboptimal CD4 recovery after 4 years of antiretroviral therapy in an African cohort. BMC infectious diseases, 11(1), 1-9.https://doi.org/10.1186/1471-2334-11-43en_US
dc.identifier.issn1471-2334
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3276
dc.language.isoenen_US
dc.publisherBMC infectious diseasesen_US
dc.subjectImmune Recovery, Sustained Viral Suppression, Suboptimal Responder, Immune Exhaustion, Joint Clinical Research Centeren_US
dc.titleHigh T-cell immune activation and immune exhaustion among individuals with suboptimal CD4 recovery after 4 years of antiretroviral therapy in an African cohorten_US
dc.typeArticleen_US
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