Acute plasma biomarkers of T cell activation set-point levels and of disease progression in HIV-1 infection

PLoS One. 2012;7(10):e46143. doi: 10.1371/journal.pone.0046143. Epub 2012 Oct 2.

Abstract

T cell activation levels, viral load and CD4(+) T cell counts at early stages of HIV-1 infection are predictive of the rate of progression towards AIDS. We evaluated whether the inflammatory profile during primary HIV-1 infection is predictive of the virological and immunological set-points and of disease progression. We quantified 28 plasma proteins during acute and post-acute HIV-1 infection in individuals with known disease progression profiles. Forty-six untreated patients, enrolled during primary HIV-1 infection, were categorized into rapid progressors, progressors and slow progressors according to their spontaneous progression profile over 42 months of follow-up. Already during primary infection, rapid progressors showed a higher number of increased plasma proteins than progressors or slow progressors. The plasma levels of TGF-β1 and IL-18 in primary HIV-1 infection were both positively associated with T cell activation level at set-point (6 months after acute infection) and together able to predict 74% of the T cell activation variation at set-point. Plasma IP-10 was positively and negatively associated with, respectively, T cell activation and CD4(+) T cell counts at set-point and capable to predict 30% of the CD4(+) T cell count variation at set-point. Moreover, plasma IP-10 levels during primary infection were predictive of rapid progression. In primary infection, IP-10 was an even better predictor of rapid disease progression than viremia or CD4(+) T cell levels at this time point. The superior predictive capacity of IP-10 was confirmed in an independent group of 88 HIV-1 infected individuals. Altogether, this study shows that the inflammatory profile in primary HIV-1 infection is associated with T cell activation levels and CD4(+) T cell counts at set-point. Plasma IP-10 levels were of strong predictive value for rapid disease progression. The data suggest IP-10 being an earlier marker of disease progression than CD4(+) T cell counts or viremia levels.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • CD4 Lymphocyte Count
  • Chemokine CXCL10 / blood
  • Chemokine CXCL10 / immunology
  • Cohort Studies
  • Cytokines / blood
  • Cytokines / immunology*
  • Disease Progression
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HIV Infections / blood
  • HIV Infections / immunology*
  • HIV Infections / virology
  • HIV-1 / immunology*
  • Humans
  • Inflammation Mediators / blood
  • Inflammation Mediators / immunology
  • Interleukin-18 / blood
  • Interleukin-18 / immunology
  • Lymphocyte Activation / immunology*
  • Male
  • Middle Aged
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism
  • Time Factors
  • Transforming Growth Factor beta1 / blood
  • Transforming Growth Factor beta1 / immunology
  • Viral Load / immunology
  • Young Adult

Substances

  • Biomarkers
  • CXCL10 protein, human
  • Chemokine CXCL10
  • Cytokines
  • Inflammation Mediators
  • Interleukin-18
  • Transforming Growth Factor beta1

Grants and funding

This work was supported by grants from the French National Agency for AIDS Research (ANRS), Institut Pasteur and the AREVA Foundation. G.P. and C.L. received a fellowship from ANRS. A-S.L. received fellowhips from the “Ministère de l’Enseignement Supérieur et de la Recherche”, “Université Paris VII-Denis Diderot” and from Sidaction. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.