Treatment of Opportunistic Infections Prior to HAART Initiation Does Not Affect Immune Reconstitution in HIV-Infected Patients
Nicole N. Huong.
In patients receiving highly active antiretroviral therapy (HAART), increase of naïve T-cell production, as
measured by T-cell receptor rearrangement excision circles (TRECs), is an indicator of immune reconstitution. Our
objective was to assess whether treating opportunistic infections (OIs) prior to HAART initiation affects CD4 T-cells
recovery and TRECs in patients on HAART. HIV-infected patients presenting no OIs or treated OIs were prospectively
enrolled prior to HAART initiation and followed-up over 12 months of HAART. CD4 T-cells and TRECs were measured
at baseline, 6 and 12 months HAART and compared between patients presenting no OIs and those with treated OIs.
Univariate and multivariate logistic regression models were used to identify potential factors associated with low TREC
increase after 12 months HAART. Forty-four HIV-infected patients, 31 presenting no OIs and 13 with treated OIs at
HAART initiation were enrolled. Patients presenting no OIs tended to have higher CD4 T-cell gain than those with treated
OIs (151 vs 89 cells/μL; p = 0.05) after 6 months HAART but not after 12 months HAART (120 vs 149 cells/μL; p =
0.84). Among patients presenting no OIs, TREC levels significantly increased from baseline through 12 months HAART
while among those with treated OIs, there was a trend for increase only after 12 months. Our study indicates that
treatment of OIs prior to HAART does not lead to impaired CD4 T-cells recovery and thymic outputs.
Keywords: T-cell receptor rearrangement excision circle, HIV, opportunistic infections, highly active antiretroviral therapy,
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