Gappoo S, Chetty P, Govender U, Harlow JD, Henry C, Honeyborne I, Mngqundaniso N, Nene N, Ntumba N, Ramduth D, Kiepiela P, Goulder P, Coovadia HM; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 398.
Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of Natal, South Africa
BACKGROUND: Both T-helper cells and CTLs are important in controlling the HIV virus. Kwa-Zulu Natal is the epicentre of HIV infection, approximately 30%. The Ekuphileni Clinic has an antenatal prevalence rate of approximately 60%. This cohort of patients (~350) has been studied over the past 4 years. Aim: To identify, those HIV-infected antenatal attendees who are controllers, normal progressors (NP) and progressors to AIDS after a 1 year follow-up period. METHOD: Immunophenotyping by flow cytometry, was undertaken at the following time points: before delivery, at 1 week, 6 weeks, 3 months, 9 months and >9 months after birth. Viral load quantification was done on the plasma sample before delivery. Antenatal attendees with CD4% of >30% and/or CD4 absolute counts of >700 cells/mm3, were classified as controllers. While CD4% of <10% and/or a CD4 absolute counts of <200 cells/mm3, were classified as progressors. Attendees falling between these values were classified as NP. The mean CD4% and CD4 absolute counts were calculated and used to categorize the patients. RESULTS: There were 33 controllers, 7 NP and 19 progressor patients in whom there was a 1 year follow-up. There was a significant difference in the CD4% and CD4 absolute values between controllers (mean +/-SD: 34.03% +/-4.17; 737 cells/mm3 +/-193.2) vs NP (18.77% +/-5.5; 449.4 cells/mm3 +/-146.5), (P<0.05; P<0.05) and progressors (11.97% +/-3.8; 194.5 cells/mm3 +/-99.7), (P<0.05; P<0.5), respectively. However the viral load in the three groups was not significantly different (P=0.09). There was no correlation between CD4% and CD4 absolute counts vs viral load in the controllers. However, there was a significant negative correlation in the progressors between the CD4% and CD4 absolute values only when the viral load is >100000 RNA copies/ml. CONCLUSION: There is a significant decline in CD4% and CD4 absolute values (<12%; <200 cells/mm3, respectively), when the viral is >100000 RNA copies/ml. Perhaps this effect could be more profound if the sample size was increased and there was a longer follow up period. The confounding variable is the unknown time of HIV infection in all three groups.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antigens, CD4
- CD4 Lymphocyte Count
- HIV Infections
- HIV Seropositivity
- Humans
- Immunophenotyping
- RNA
- RNA, Viral
- T-Lymphocytes, Cytotoxic
- Viral Load
- immunology
Other ID:
UI: 102262683
From Meeting Abstracts