{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T08:18:28Z","timestamp":1778746708909,"version":"3.51.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","funder":[{"DOI":"10.13039\/100006492","name":"Division of Intramural Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["ZIC DE000729-09"],"award-info":[{"award-number":["ZIC DE000729-09"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite suppressive antiretroviral therapy (ART), 15%\u201330% of people with human immunodeficiency virus (HIV) experience a limited recovery of CD4 T cells. Although autoantibodies against the CD4 receptor have previously been identified in people with HIV (PWH), little is known about their longitudinal impact on CD4 T-cell reconstitution.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Anti-CD4 autoantibodies were evaluated by the fluid-phase luciferase immunoprecipitation systems immunoassay in ART-naive people with advanced HIV (CD4 count \u2264100\u2005cells\/\u00b5L), PWH with CD4 count &amp;gt;200\u2005cells\/\u00b5L, long-term nonprogressors, people with idiopathic CD4 lymphopenia, people with autoimmune lymphoproliferative syndrome, and healthy volunteers without HIV. In the participants with advanced HIV, we assessed the association of anti-CD4 autoantibodies at ART initiation with CD4 recovery over a median follow-up of 192 weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Anti-CD4 autoantibodies were identified in 29% (61\/210) of ART-naive participants with advanced HIV but were absent in people without HIV. Female PWH showed a 4-fold higher prevalence (P &amp;lt; .001) of anti-CD4 autoantibodies compared to males. After ART initiation, people with advanced HIV with anti-CD4 autoantibodies exhibited an overall slower rate of CD4 reconstitution (5.8 vs 6.6\u2005cells\/\u00b5L\/month, P = .007) and lower week 192 CD4 count (268 vs 355\u2005cells\/\u00b5L, P = .037). Incidental, clinically indicated immunosuppressive therapy in these participants was associated with an improved rate of CD4 reconstitution (P = .0019) and higher week 192 CD4 count (551 vs 268\u2005cells\/\u00b5L, P = .019).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>People with advanced HIV harboring anti-CD4 autoantibodies at ART initiation demonstrated a slower rate and extent of CD4 reconstitution after 4 years. Incidental immunosuppressive therapy was associated with increased CD4 counts in these participants.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae562","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T15:26:10Z","timestamp":1731079570000},"page":"1340-1348","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Anti-CD4 Autoantibodies on Immune Reconstitution in People With Advanced HIV"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7434-942X","authenticated-orcid":false,"given":"Brian P","family":"Epling","sequence":"first","affiliation":[{"name":"Laboratory of Immunoregulation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1475-356X","authenticated-orcid":false,"given":"Andrea","family":"Lisco","sequence":"additional","affiliation":[{"name":"Laboratory of 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Immunoregulation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Laboratory of Immunoregulation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6062-8022","authenticated-orcid":false,"given":"Stephen A","family":"Migueles","sequence":"additional","affiliation":[{"name":"Laboratory of Immunoregulation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Poole","sequence":"additional","affiliation":[{"name":"Laboratory of Immunoregulation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ainhoa","family":"Perez-Diez","sequence":"additional","affiliation":[{"name":"Laboratory of Immunoregulation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangdong","family":"Liu","sequence":"additional","affiliation":[{"name":"Laboratory of Immunoregulation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7881-6902","authenticated-orcid":false,"given":"V Koneti","family":"Rao","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1717-048X","authenticated-orcid":false,"given":"Peter D","family":"Burbelo","sequence":"additional","affiliation":[{"name":"Adeno-Associated Virus Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health , Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0076-0224","authenticated-orcid":false,"given":"Irini","family":"Sereti","sequence":"additional","affiliation":[{"name":"Laboratory of 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