CD4+ Lymphocyte Increases in HIV Patients during Potent Antiretroviral Therapy Are Dependent on Inhibition of CD8+ Cell Apoptosis

doi:10.1196/annals.1299.104

SANDRO GRELLI^a, GABRIELLA D'ETTORE^b, FILIPPO LAURIA^c, FRANCESCO MONTELLA^c, LOIDE DI TRAGLIA^a, CARTESIO D'AGOSTINI^a, MIRIAM LICHTNER^b, VINCENZO VULLO^b, CARTESIO FAVALLI^a, STEFANO VELLA^d, BEATRICE MACCHI^e,f AND ANTONIO MASTINO^g

^aDepartment of Experimental Medicine and Biochemical Science, "Tor Vergata," University Hospital, 00133 Rome, Italy
^bDepartment of Infectious and Tropical Diseases, University of Rome, "La Sapienza," viale del Policlinico 155, 00161 Rome, Italy
^cS. Giovanni Hospital, via Amba Aradam 9, 00184, Rome, Italy
^dIstituto Superiore Sanita, viale Regina Elena 299, Rome, Italy
^eDepartment of Neuroscience, University of Rome, "Tor Vergata," via Montpellier 1, 00133 Rome, Italy
^fIRCCS, S. Lucia, via Ardeatina 306, 00179 Rome, Italy
^gDepartment of Microbiology, Genetics, and Molecular Science, University of Messina, salita Sperone 31, 98166 Messina, Italy

Address for correspondence: Antonio Mastino, Department of Microbiology, Genetics, and Molecular Science, University of Messina, salita Sperone 31, 98166 Messina, Italy. Voice: +39-090-6765198; fax: +39-090-392733. mastino{at}med.uniroma2.it
Ann. N.Y. Acad. Sci. 1010: 560-564 (2003).

Although suppression of apoptosis contributes to immune-reconstitutionduring potent antiretroviral therapy, its relationship withthe majors indicators of response to therapy, that is, changesin CD4⁺ cell counts and in viral loads (VL), is still debated.We extended our previous study by collecting data on the relationshipsamong apoptosis and immunological and virological parametersduring a long-term follow-up of HIV patients with an overallpositive response to potent antiretroviral therapy. We reportresults from 15 patients who completed two years of therapy.In a smaller group of patients, we focused our attention oninvestigating the specific contribution of the CD8⁺ subset inthe overall changes in lymphocyte apoptosis, which occur concomitantlywith the response to the therapy. Our data, while again confirmingthat inhibition of PBMC apoptosis is a phenomenon strictly relatedto a positive response to potent antiretroviral therapy, suggestthat CD4⁺ cell rescue is not directly dependent on inhibitionof CD4⁺ cell apoptosis but rather on that of the CD8⁺ subset.