Immunophenotypic Markers and Antiretroviral Therapy (IMART): T Cell Activation and Maturation Help Predict Treatment Response

Abstract

To determine whether markers of T cell activation and maturation are independently predictive of the response to potent antiretroviral therapy, the Immunophenotypic Markers and Antiretroviral Therapy study applied a novel data-sharing strategy across 5 Adult AIDS Clinical Trial Group trials that counted naive and activated CD4⁺ and CD8⁺ T cells in 324 subjects. Regression models—adjustment for baseline CD4 cell count, human immunodeficiency virus (HIV) RNA, and study—revealed that high pretreatment CD8⁺ T cell activation predicted virologic failure ( P = .046). Additional models showed the greatest increase in CD4⁺ T cell counts in subjects with highest pretreatment naive CD4⁺ T cell counts ( P < .0001 ), which was enhanced by high CD4⁺ and low CD8⁺ T cell activation. Total lymphocyte count also predicted a subsequent CD4⁺ T cell change. These results document the utility of T cell markers in predicting treatment outcome and their potential value for the study and management of HIV-1 infection.