Poor functional immune recovery in aged HIV-1-infected patients following successfully treatment with antiretroviral therapy

Hum Immunol. 2015 Oct;76(10):701-10. doi: 10.1016/j.humimm.2015.09.023. Epub 2015 Sep 30.


Aging is now a well-recognized characteristic of the HIV-infected population and both AIDS and aging are characterized by a deficiency of the T-cell compartment. The objective of the present study was to evaluate the impact of antiretroviral (ARV) therapy in recovering functional response of T cells to both HIV-1-specific ENV peptides (ENV) and tetanus toxoid (TT), in young and aged AIDS patients who responded to ARV therapy by controlling virus replication and elevating CD4(+) T cell counts. Here, we observed that proliferative response of T-cells to either HIV-1-specific Env peptides or tetanus toxoid (TT) was significantly lower in older antiretroviral (ARV)-treated patients. With regard to cytokine profile, lower levels of IFN-γ, IL-17 and IL-21, associated with elevated IL-10 release, were produced by Env- or TT-stimulated T-cells from older patients. The IL-10 neutralization by anti-IL-10 mAb did not elevate IFN-γ and IL-21 release in older patients. Finally, even after a booster dose of TT, reduced anti-TT IgG titers were quantified in older AIDS patients and it was related to both lower IL-21 and IFN-γ production and reduced frequency of central memory T-cells. Our results reveal that ARV therapy, despite the adequate recovery of CD4(+) T cell counts and suppression of viremia, was less efficient in recovering adequate immune response in older AIDS patients.

Keywords: Antiretroviral therapy; Elderly; HIV; Immune recovery; Tetanus toxoid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aging / immunology*
  • Aging / pathology
  • Anti-HIV Agents / therapeutic use*
  • Antibodies, Viral / biosynthesis
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / drug effects
  • CD4-Positive T-Lymphocytes / immunology*
  • CD4-Positive T-Lymphocytes / virology
  • Case-Control Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology*
  • HIV Infections / pathology
  • HIV Infections / virology
  • HIV-1 / immunology*
  • Humans
  • Interleukin-10 / biosynthesis
  • Interleukin-10 / immunology
  • Interleukin-17 / biosynthesis
  • Interleukin-17 / immunology
  • Interleukins / biosynthesis
  • Interleukins / immunology
  • Male
  • Middle Aged
  • Peptides / pharmacology
  • Primary Cell Culture
  • Tetanus Toxoid / pharmacology
  • Viral Load / drug effects
  • Viral Proteins / pharmacology
  • Virus Replication / drug effects


  • Anti-HIV Agents
  • Antibodies, Viral
  • IL10 protein, human
  • Interleukin-17
  • Interleukins
  • Peptides
  • Tetanus Toxoid
  • Viral Proteins
  • Interleukin-10
  • interleukin-21