The Impact of Highly Active Antiretroviral Treatment on the Blood Profiles of Patients with Acquired Immune Deficiency Syndrome

Outcomes of highly active antiretroviral therapy and its predictors: a cohort study focusing on tuberculosis co-infection in South West Ethiopia

BACKGROUND

In this study, we hypothesized that TB co-infection independently increases the risk of poor treatment outcomes in such patients even if they are on antiretroviral therapy (ART). Therefore, this study was aimed at investigating this hypothesis among cohort of adult PLWHs in South West Ethiopia.

METHODOLOGY

Cohort study comparing the immunologic and clinical outcomes of 130 HIV/TB co-infected and 520 only HIV patients starting ART was enrolled. Chi square and student t test were used to compare outcome variables and logistic regression was used to assess the effect of TB on treatment failure.

RESULTS

In this study, TB co-infection didn't increase immunologic failure even in univariate analysis at both 6 [OR, 1.10 (0.59-1.69), P = 0.85] and 12 months [OR, 1.06 (0.58-1.93), P = 0.89] of ART initiation. However, it increased the risk of clinical failure at both 6 [Adjusted Odd Ratio (AOR), 2.90 (1.41-6.09), P = 0.028] and 12 months [AOR, 2.93 (1.41-6.09), P = 0.004] of ART initiation.

CONCLUSION

This study showed that TB co-infection didn't adversely affect the immunologic outcomes, weight and hemoglobin responses even though it increased the risk of clinical failure nearly three times. Therefore, beside the concern given for TB prevention and treatment, several patient and policy related factors need to be addressed to maximally benefit from highly active antiretroviral therapy rollout in resource limited settings.

Impact of highly active antiretroviral treatment on expression of HIV-1 coreceptors and ligand levels in peripheral blood from HIV-1 infected patients in China

OBJECTIVE

Coreceptors are important for HIV-1 entry into target cells and disease progression. The impact of HIV-1 and highly active antiretroviral treatment (HAART) on coreceptor expression has been little studied.

METHODS

Expression of C-C chemokine receptor (CCR) 5 and C-X-C chemokine receptor (CXCR) 4 on CD4+ and CD8 + T cells was compared in HIV-1-infected individuals who had/had not received HAART, and in healthy controls. Relationships between coreceptors and their chemokine ligands were studied.

RESULTS

This study included 23 controls and 88 HIV-1-infected individuals, 35 of whom were HAART naïve. Percentages of CCR5 and CXCR4+ CD8 + T cells were higher, and CXCR4+ CD4 + T cells were lower, in patients than in controls. Patients receiving HAART showed a higher percentage of CCR5 expression on CD4 + T cells compared with HAART-naïve patients. HIV-infected individuals had significantly increased levels of peripheral ligands for coreceptors, compared with controls; levels were significantly higher in those receiving HAART compared with the HAART-naïve.

CONCLUSIONS

HIV-1 infection increases coreceptor expression on T cells; HAART increases CCR5 expression further and decreases CXCR4 expression, reversing the switch from CCR5 to CXCR4, which was significant for CD4 + T.