Prospective Study of CD8 + Lymphocyte Activation in Relation to Viral Load in HIV-Infected Patients with >=400 CD4 + Lymphocytes per Microliter

Abstract

To investigate the temporal relationship between CD8⁺ lymphocyte phenotypic alterations, the CD4⁺ T cell decline, and plasma HIV RNA levels during the natural history of HIV infection, 33 treatment-naive HIV-infected patients with >=400 CD4⁺ cells/mu l were studied prospectively for 3 years. During the study period, 20 patients remained untreated, and only 6 received more than 6 months of therapy. A significant relationship was found between changes in plasma HIV RNA and changes in the proportion of CD38⁺CD8⁺ cells. Conversely, the number of CD4⁺ T cells lost per year was strongly related to the increase in the proportion of CD28^-CD8⁺ T cells. A strong relationship between mean yearly changes in CD4⁺ T cell numbers and changes in HIV RNA was also observed. CD4⁺ T cell changes were associated with changes in both viral load and CD8⁺ T cell activation. These results provide support for the use of both virologic and immunologic parameters for prognosis and management during HIV infection.