title: Patterns of CD4+ cell changes after HIV-1 infection indicate the existence of a codeterminant of AIDS.
abstract: Successive interval slopes of CD4+ cells each constructed from levels at three consecutive 6 month visits were compared over 3 years of follow-up among 565 persistently HIV-1 antibody-positive, 326 persistently antibody-negative, and 51 seroconverting homosexual men who had at least 500 CD4+ cells/mm3 at baseline and completed the first three 6 month visits. "Change" was defined as a difference between two successive interval slopes. Sixty-two percent of seroconverters meeting these criteria experienced a shift in one or more of their successive CD4+ interval slopes, the majority (56%) from a level slope to a negative slope (decreasing numbers of CD4+ cells), a significantly greater proportion than that observed among seronegatives (30%, p less than 0.0001). Fifty-eight percent of the seropositives maintained level interval slopes over the 3 years of follow-up. The majority (59%) of those men experiencing a shift went from a level to a negative interval slope, a significantly greater proportion than observed among seronegatives (30%, p less than 0.0001). The observed patterns of change in interval slopes are consistent with the laboratory observation that CD4+ cells must be activated to replicate HIV-1. The use of the interval slope strategy provides a method to identify a temporal focal point at which to examine possible codeterminants that trigger the production of HIV-1 and the subsequent decline in CD4+ cells.
authors.affiliation: Multicenter AIDS Cohort Study, National Institute of Allergy and Infectious Disease, Bethesda, Maryland.
authors.forename: R
authors.initials: R
authors.lastname: Detels
authors.forename: P A
authors.initials: PA
authors.lastname: English
authors.forename: J V
authors.initials: JV
authors.lastname: Giorgi
authors.forename: B R
authors.initials: BR
authors.lastname: Visscher
authors.forename: J L
authors.initials: JL
authors.lastname: Fahey
authors.forename: J M
authors.initials: JM
authors.lastname: Taylor
authors.forename: J P
authors.initials: JP
authors.lastname: Dudley
authors.forename: P
authors.initials: P
authors.lastname: Nishanian
authors.forename: A
authors.initials: A
authors.lastname: Muñoz
authors.forename: J P
authors.initials: JP
authors.lastname: Phair
mesh_terms: D015492:AIDS Serodiagnosis; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000209:etiology / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000145:classification / Q000166:cytology*; D006679:HIV Seropositivity / Q000097:blood* / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D007958:Leukocyte Count; D008297:Male; D015337:Multicenter Studies as Topic; D013997:Time Factors