Usefulness of MT-2 assay to decide when to start anti-HIV therapy

Abstract

It is well known that the emergence of syncytium inducing (SI) variant correlates accelerated CD4 decline and disease progression during the course of HIV infection. We have conducted a clinical study to investigate whether or not detection of SI by MT-2 cells (MT-2 assay) can be a clinical marker to decide when to start anti-HIV therapy since 1995. We examined 483 blood samples obtained from 172 HIV-infected patients by the MT-2 assay. SI was detected from 20 patients. There were five untreated patients whose CD4 counts were 300/microliter or more. Anti-HIV combination therapies were started soon after detection of SI in all of them. We have followed their clinical courses for more than 4 years, so far, in three of them. Their CD4 counts and clinical courses were both stable. In contrast, in another patient who could not receive any anti-HIV therapy even though SI positive, decline of CD4 was very rapid (200/microliter/year) and the disease progressed to AIDS within one year as like other SI positive cases before the era of several approved anti-HIV drugs. According to these distinct prognosis, the MT-2 assay might be a useful clinical marker for deciding anti-HIV therapy at least in our limited cases.