Plasma levels of soluble CD27: a simple marker to monitor immune activation during potent antiretroviral therapy in HIV‐1‐infected subjects

• Published in: Clinical and experimental immunology Vol. 127; no. 3; pp. 486 - 494
• Main Authors: MILITO, A. DE, ALEMAN, S., MARENZI, R., SÖNNERBORG, A., D, FUCHS, ZAZZI, M., CHIODI, F.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-03-2002; Blackwell; Oxford University Press; Blackwell Science Inc
• Subjects: Antiretroviral Therapy, Highly Active; Biological and medical sciences; Biomarkers - blood; CD4 Lymphocyte Count; Clinical Studies; Cross-Sectional Studies; Follow-Up Studies; HAART; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV-1 - genetics; HIV‐1; Human viral diseases; Humans; immune activation; Infectious diseases; Lymphocyte Activation; Medical sciences; Medicin och hälsovetenskap; neopterin; Neopterin - blood; RNA, Viral - analysis; soluble CD27; T-Lymphocytes - immunology; Tumor Necrosis Factor Receptor Superfamily, Member 7 - blood; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Human; Membrane protein; Immune response; HIV-1 virus; Retroviridae; Biological marker; AIDS; Activation; Soluble form; Lentivirus; Biological monitoring; Infection; Virus; Chemotherapy; Treatment; Viral disease; T-Lymphocyte; Antiviral; Human immunodeficiency virus; Neopterin
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1046/j.1365-2249.2002.01786.x

SUMMARY
Plasma levels of soluble CD27 (sCD27) are elevated in diseases characterized by T cell activation and are used as a marker of immune activation. We assessed the usefulness of determining plasma sCD27 as a marker for monitoring immune activation in HIV‐1‐infected patients treated with highly active antiretroviral therapy (HAART). A first cross‐sectional examination of 68 HIV‐1‐infected and 18 normal subjects showed high levels of sCD27 in HIV‐1 infection; plasma sCD27 was correlated to HIV‐1 viraemia and inversely correlated to CD4+ T cell count. Twenty‐six HIV‐1‐infected
patients undergoing HAART were studied at baseline and after 6, 12, 18 and 24 months
of therapy. Seven additional patients under HAART were analysed at baseline, during
and after interruption of therapy. In the total population, HAART induced a significant
and progressive reduction, but not a normalization, of plasma levels of sCD27 after
24 months. A full normalization of plasma sCD27 was observed in the virological responders
(undetectable HIV‐1 RNA at months 18 and 24) and also in patients with moderate immunodeficiency
at baseline (CD4+ T cell count >200 cells/mm3). Changes
in plasma neopterin paralleled the changes in sCD27 but only baseline sCD27 levels
were predictive of a greater increase in CD4+ T cell count during the
follow‐up. Discontinuation of therapy resulted in a rapid increase of sCD27 plasma
levels associated with viraemia rebound and drop in CD4+ T cell count. Our findings suggest that plasma sCD27 may represent an alternative and simple marker to monitor immune activation during potent antiretroviral therapy. HIV‐1‐induced immune activation can be normalized by HAART in successfully treated patients where the disease is not advanced.