Measurement of naive CD4 cells reliably predicts potential for immune reconstitution in HIV

Timothy W. Schacker, Ronald J. Bosch, Kara Bennett, Richard Pollard, Gregory K. Robbins, Ann C. Collier, Roy M. Gulick, John Spritzler, Donna Mildvan

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background: Pathogenesis studies show that naive CD4 cells are preferentially depleted in lymphoid tissues during HIV infection, and studies of advanced patients suggest levels of naive CD4 cells in blood correlate to total CD4 cells after starting antiretroviral therapy (ARV). We hypothesized that measuring naive CD4 cells in blood in people at earlier stages of disease would identify those at highest risk for poor CD4 reconstitution who may benefit from earlier initiation of ARV. Methods and Findings: We identified 348 patients from multiple AIDS Clinical Trials Group studies who were ARV naive, had a CD4 count between 200 and 500 cells per microliter, a measure of pretreatment-naive CD4 percent, and serial follow-up measures of CD4 count and plasma HIV RNA after starting ARV. We used logistic regression to model the ability of naive CD4 percent to predict 100 and 200 CD4 cell increases after 24 months of therapy. After controlling for baseline viral load and demographic variables, baseline naive but not total CD4 cell count strongly predicted CD4 cell increases. Lower baseline naive CD4 percent was associated with greater time spent at lower CD4 T-cell counts after initiating ARV. Conclusions: Measurement of naive CD4 percent in patients can identify those least likely to reconstitute immunity, who may benefit from earlier ARV treatment.

Original languageEnglish (US)
Pages (from-to)59-62
Number of pages4
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number1
StatePublished - May 2010


  • Early therapy
  • Immune reconstitution
  • Naive CD4 T cells


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