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1 From the Southern California HIV/Eye Consortium; the 2 Ocular Inflammatory Disease Center, Jules Stein Eye Institute, Los Angeles, California; the 3 Departments of Ophthalmology and 9 Medicine, University of California Los Angeles (UCLA) School of Medicine, Los Angeles, California; 8 Community Eye Medical, Pasadena, California; the 4 UCLA AIDS Institute, Center for AIDS Research, and the 5 Department of Biostatistics, UCLA School of Public Health, Los Angeles, California; the 6 Departments of Physiology and Biophysics, 10 Medicine, and the 7 Doheny Eye Institute, Department of Ophthalmology, University of Southern California (USC) Keck School of Medicine, Los Angeles, California.
PURPOSE. To determine whether polymorphonuclear leukocytes (PMNs) remain rigid after immune reconstitution in human immunodeficiency virus (HIV)-infected individuals with a history of severe immunosuppression.
METHODS. PMN rigidity was measured in vitro in three groups: (1) HIV-infected individuals with a history of CD4+ T-lymphocyte counts of less than 50/µL, but with current counts of more than 200/µL attributable to potent antiretroviral therapy (group 1); (2) HIV-infected individuals whose CD4+ T-lymphocyte counts had always been more than 200/µL (group 2); and (3) HIV-negative control subjects. Rigidity was determined with a cell transit analyzer (containing a micropore filter with 30 identical, 8-µm diameter pores), representing a simple in vitro model of a capillary bed. A longer PMN pore transit time reflects increased PMN rigidity.
RESULTS. PMN transit time (median) in group 1 (n = 11) was 3.34 ms, in group 2 (n = 9) was 3.19 ms, and in control subjects (n = 15) was 2.66 ms. PMN rigidity was significantly greater in groups 1 (P = 0.014) and 2 (P = 0.046) than in control subjects (Wilcoxon rank-sum test). A significant difference was not identified between groups 1 and 2 (P = 0.518).
CONCLUSIONS. The increased PMN rigidity known to occur in severely immunosuppressed HIV-infected individuals persists after immune reconstitution. Furthermore, PMN rigidity is increased in those HIV-infected individuals who do not have a history of severe immunosuppression. Because PMN rigidity can alter microvascular blood flow, HIV-infected individuals may remain at risk for retinal vascular damage in the era of potent antiretroviral therapy.
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