Characteristics of suboptimal immune response after initiating antiretroviral therapy among people living with HIV with a pre-treatment CD4 T cell count <200 cells/mm3 in Thailand
Win Min Han, Sasiwimol Ubolyam, Tanakorn Apornpong, Stephen J. Kerr, Pokrath Hansasuta, Sivaporn Gatechompol, Wirach Maek-a-nantawat, Kiat Ruxrungtham, Praphan Phanuphak, Jintanat Ananworanich, Anchalee Avihingsanon
Abstract
BACKGROUND: Complete recovery of the CD4 T cell count is uncommon among chronically HIV-infected individuals with very low pre-treatment CD4 count. We studied the prevalence of chronically immune recovery and its associated factors including immune characteristics chronic HIV-infected Thais. METHODS: for 3 years after ART initiation. A case-control sub-study matched for age, sex and pre-ART CD4 T cell count was conducted to compare immunological characteristics between SIR (n = 17) and non-SIR (n = 24) participants. Immunological biomarkers such as interleukin-7 (IL-7) and soluble CD14 (sCD14) and other covariates including cytomegalovirus (CMV) DNA level, baseline hemoglobin level, hepatitis B and C co-infections, and T cell subsets associated with immune activation and exhaustion were evaluated. RESULTS: T cells (74.2% vs. 65.1%, p = 0.02) observed in SIR participants compared to their non-SIR counterparts at year 3 after ART initiation. CONCLUSIONS: after 3 years of ART which was with a very low pre-ART CD4 T cell count and older age. The long-term clinical outcomes of SIR participants need to be further explored.