Factors Influencing Immune Restoration in People Living with HIV/AIDS

Introduction: Immune restoration is a key clinical aspect that is pursued in the care of human immunodeficiency virus (HIV)-infected patients. Despite effective antiretroviral treatment and undetectable viremia, immune recovery is often incomplete. Materials and methods: Data from 311 Caucasian patients were collected. SNP in CCR2(rs1799864), CX3CR1(rs3732378), HLAC-35(rs9264942), and CCR5(promoter, rs1799988); a 32bp deletion(Delta 32) in CCR5; and HLA-B*5701 genotypes were correlated with clinical data and selected endpoints. Kaplan-Meier and Cox proportional hazards models were used to analyze the effects of genetic factors over time. Results: For HLA-B*5701, the effect on the CD4+/CD8+ >0.8 cell ratio was lost within 48 months (HR = 2.04, 95% CI: 1.04-4.03), and the effect on the CD4+ cell count >500 cells/mu L was lost within 12 months (HR = 2.12, CI: 1.11-4.04). The effect of CCR2 GG on the CD4+/CD8+ >0.8 cell ratio was lost within 36 months (HR = 1.7, CI: 1.05-2.75). For CCR5 wt/Delta 32, the effect on the CD4+/CD8+ >1.0 cell ratio was lost within 24 months (HR = 2.0, CI: 1.08-3.69), and the effect on the CD4+ >800 cells/mu L cell count was lost within 18 months (HR = 1.98, CI: 1.14-4.73). Conclusions: Selected genetic polymorphisms, namely CCR2 GG and CCR5 Delta 32, and the presence of the HLA-B*5701 allele positively influenced immune restoration in cART-treated patients with HIV/AIDS.