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

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.