T-cell subset alterations and lymphocyte responsiveness to mitogens and antigen during severe primary infection with HIV: a case series of seven consecutive HIV seroconverters.
Seven consecutive patients who presented with a severe acute mononucleosis-like illness associated with HIV seroconversion were evaluated by T-cell subset enumerations and measurements of lymphocyte transformation responses to mitogens and antigen during both their primary illness and a 1-year follow-up period. We observed a characteristic pattern of response to primary HIV infection; initial lymphopenia was followed by CD8 lymphocytosis and inversion of the CD4:CD8 ratio. During follow-up, the CD8 count gradually returned to normal, whereas the CD4:CD8 ratio remained inverted because of a relatively low number of CD4 lymphocytes. Primary infection was followed by prolonged and severe cellular hyporesponsiveness to both mitogens and antigen. At the last follow-up, responses to pokeweed mitogen were still severely impaired, with a median 19% (range 7-50%) of that observed in healthy controls. We conclude that severe primary HIV infection may be followed by sustained lymphocyte hyporesponsiveness, a sustained low percentage of CD4 lymphocytes and sustained inversion of the CD4:CD8 ratio.
Pedersen
C
C
Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark.
Dickmeiss
E
E
Gaub
J
J
Ryder
L P
LP
Platz
P
P
Lindhardt
B O
BO
Lundgren
J D
JD
D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D015683:Gene Products, gag / Q000276:immunology; D015488:HIV Antigens / Q000276:immunology*; D016655:HIV Core Protein p24; D006679:HIV Seropositivity / Q000276:immunology*; D006716:Homosexuality; D006801:Humans; D007958:Leukocyte Count; D008213:Lymphocyte Activation / Q000187:drug effects; D008934:Mitogens / Q000494:pharmacology; D050378:T-Lymphocytes, Regulatory / Q000187:drug effects / Q000276:immunology*; D014758:Viral Core Proteins / Q000276:immunology
D015683:Gene Products, gag; D015488:HIV Antigens; D016655:HIV Core Protein p24; D008934:Mitogens; D014758:Viral Core Proteins