PLoS ONE (Jan 2019)

Naïve/Effector CD4 T cell ratio as a useful predictive marker of immune reconstitution in late presenter HIV patients: A multicenter study.

  • Veronica Bordoni,
  • Bruno Brando,
  • Pierluca Piselli,
  • Olindo Forini,
  • Federico Enrico Perna,
  • Umberto Atripaldi,
  • Sara Carputo,
  • Federica Garziano,
  • Elisabetta Trento,
  • Giovanna D'Agosto,
  • Alessandra Latini,
  • Manuela Colafigli,
  • Antonio Cristaudo,
  • Alessandra Sacchi,
  • Massimo Andreoni,
  • Gabriella De Carli,
  • Nicoletta Orchi,
  • Sandro Grelli,
  • Arianna Gatti,
  • Carlotta Cerva,
  • Antonella Minutolo,
  • Marina Potestà,
  • Maria Luisa Di Martino,
  • Francesco Ortu,
  • Paola Selva,
  • Laura Del Pup,
  • Irene Guarnori,
  • Patrizia Lorenzini,
  • Giusy Capuano,
  • Andrea Antinori,
  • Chiara Agrati

DOI
https://doi.org/10.1371/journal.pone.0225415
Journal volume & issue
Vol. 14, no. 12
p. e0225415

Abstract

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A significant proportion of HIV-infected patients experiencing a late diagnosis highlights the need to define immunological protocols able to help the clinicians in identifying patients at higher risk for immunological failure. The aim of the study was to evaluate the feasibility of easy cytometric tests in defining the effect of antiretroviral treatment (cART) on immunological homeostasis and in identifying predictive markers of early immune recovery. Chronic HIV infected patients (n = 202) were enrolled in a prospective multicentric study, and their immunological profile was studied before (w0) and after 24 weeks (w24) of antiretroviral treatment (cART) using a standardized flow cytometric panel. Based on CD4 T cell count before treatment, patients were divided in late (LP: CD4 500/mmc) presenters. In all groups, cART introduction increased CD4 and CD4/CD8 T cell ratio, naïve T cell (CD4 and CD8) and CD127-expressing CD4 T cells. In parallel, cART significantly reduced effector memory T cells (CD4 and CD8) and T cell activation (CD38+CD8 and CD95+CD4 T cells). Moreover, the frequency of Naïve and Effector CD4 T cells before treatment correlated with several immune parameters key associated with the pathogenesis of HIV, thus mirroring the health of immune system. Interestingly, we identified the Naïve/Effector CD4 T cell ratio (N/EM) at w0 as a marker able to predict early immune recovery. Specifically, in LP, N/EM ratio was significantly higher in immunological responder patients (CD4>500/mmc at w24) when compared to immunological non responder (CD4 T cells <500/mmc at w24). Finally, a multivariate analysis indicates that after 24w patients with N/EM ratio higher than 1.86 at w0 recovered 96 CD4 T cells more than those with N/EM ratio lower than 0.46. Altogether, our data define an easy protocol able to define reliable immunological markers useful for the characterization of immune profile in viremic HIV patients and identify the naïve/effector CD4 T cell ratio as a new tool able to predict an early immune reconstitution potential.