Short Communication: Immune Reconstitution after Autologous Peripheral Blood Stem Cell Transplantation in HIV-Infected Patients: Might Be Better Than Expected?

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Abstract
We carried out a longitudinal study to analyze the immune recovery of four patients with aggressive HIV-associated lymphoma (HIV+ Ly+) treated with highly active antiretroviral therapy (HAART) and high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT). We also studied three control non-HIV-infected patients with lymphoma (HIV− Ly+) and six HIV patients on HAART without lymphoma (HIV+ Ly−). After 12 months of follow-up, the HIV HIV+ Ly+ patients reached the pre-ASCT CD4+ levels, despite a transient decrease after the ASCT. All ASCT patients (HIV+ Ly+ and HIV− Ly+) showed an increase in CD4+, CD4+ CD45RO+, and CD4+CD28+ T cells/μl. Although HIV+Ly+ patients had values of CD4+, CD4+ CD45RO+, and CD4 CD28+ T cells/μl lower than the HIV− Ly+ patients, their recovery rate over the 12 months after ASCT appeared to be better. HIV+ Ly+ patients had higher pre-ASCT plasma IL-7 levels than HIV− Ly+, however, these values decreased after ASCT. All ASCT patients showed a slight increase of TCR rearrangement excision circles (TRECs) and they did not have a different pattern of TREC evolution. We could not find differences between HIV+ Ly+ patients 12 months after ASCT and HIV+ Ly− in DNA-HIV (copies/106 cell). Overall, HIV+ Ly+ patients showed an appropriate immune reconstitution 12 months after ASCT, and, interestingly, they had an amount of DNA-HIV copies similar to HIV+ Ly− control patients in their CD4+ cells.