Reduced Central Memory CD4+ T Cells and Increased T-Cell Activation Characterise Treatment-Naive Patients Newly Diagnosed at Late Stage of HIV Infection

Abstract EN

Objectives.

We investigated immune phenotypes of HIV+ patients who present late, considering late presenters (LPs, CD4+ < 350/μL and/or AIDS), advanced HIV disease (AHD, CD4+ < 200/μL and/or AIDS), and AIDS presenters (AIDS-defining condition at presentation, independently from CD4+).

Methods.

Patients newly diagnosed with HIV at our clinic between 2007–2011 were enrolled.

Mann-Whitney/Chi-squared tests and logistic regression were used for statistics.

Results.

275 patients were newly diagnosed with HIV between January/2007–March/2011.

130 (47%) were LPs, 79 (29%) showed AHD, and 49 (18%) were AIDS presenters.

LP, AHD, and AIDS presenters were older and more frequently heterosexuals.

Higher CD8+%, lower CD127+CD4+%, higher CD95+CD8+%, CD38+CD8+%, and CD45R0+CD38+CD8+% characterized LP/AHD/AIDS presentation.

In multivariate analysis, older age, heterosexuality, higher CD8+%, and lower CD127+CD4+% were confirmed associated with LP/AHD.

Lower CD4+ and higher CD38+CD8+% resulted independently associated with AIDS presentation.

Conclusions.

CD127 downregulation and immune activation characterize HIV+ patients presenting late and would be studied as additional markers of late presentation.