Elevated levels of CD38+ CD8+ T cells in HIV infection add to the prognostic value of low CD4+ T cell levels: results of 6 years of follow-up. The Los Angeles Center, Multicenter AIDS Cohort Study.
A cohort of 98 HIV-infected initially AIDS-free homosexual men from the Multicenter AIDS Cohort Study (MACS) was followed for 6 years to investigate whether CD8+ cell subsets have prognostic value for progression to AIDS. In the present study, four subsets of CD8+ T cells that previously have been shown to be selectively elevated in HIV-infected asymptomatic persons, specifically the CD8+ T cell subsets that were CD38+, HLA-DR+, CD57+ and L-selectin negative (Leu8-), were measured. Forty-nine of the 98 developed AIDS. Prognostic value of these CD8+ cell subsets was evaluated using the proportional hazards model. Levels of both CD38+ CD8+ and Leu8- CD8+ cells individually had prognostic value for progression to AIDS. In contrast, CD57+ CD8+ and HLA-DR+ CD8+ cell subsets levels did not have prognostic value. After adjustment for level of CD4+ T cells, however, only the elevation in the CD38+ CD8+ cell subset had additional prognostic value. These results suggest that the level of CD38+ CD8+ cells could be used together with the CD4+ T cell level to more accurately predict progression to AIDS among HIV-infected men. These results provide further support for the observation that dramatic and progressive activation of CD8+ T cells in HIV infection occurs. The power of elevated levels of the CD38+ CD8+ subset to predict poor prognosis in this cohort suggests these CD8+ T cells reflect an immune stimulation that is ultimately unable to control disease progression.
Giorgi
J V
JV
Department of Medicine, UCLA School of Medicine 90024-1745.
Liu
Z
Z
Hultin
L E
LE
Cumberland
W G
WG
Hennessey
K
K
Detels
R
R
D036541:ADP-ribosyl Cyclase; D051997:ADP-ribosyl Cyclase 1; D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology* / Q000276:immunology; D015703:Antigens, CD / Q000032:analysis; D000943:Antigens, Differentiation / Q000032:analysis*; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018959:CD57 Antigens; D016827:CD8 Antigens / Q000032:analysis*; D015815:Cell Adhesion Molecules / Q000032:analysis; D015331:Cohort Studies; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology*; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D019041:L-Selectin; D007958:Leukocyte Count; D008297:Male; D008562:Membrane Glycoproteins; D015337:Multicenter Studies as Topic; D011379:Prognosis; D016016:Proportional Hazards Models; D016176:T-Lymphocyte Subsets / Q000276:immunology*
D015703:Antigens, CD; D000943:Antigens, Differentiation; D000945:Antigens, Differentiation, T-Lymphocyte; D018959:CD57 Antigens; D016827:CD8 Antigens; D015815:Cell Adhesion Molecules; D006684:HLA-DR Antigens; D008562:Membrane Glycoproteins; D019041:L-Selectin; D036541:ADP-ribosyl Cyclase; C498154:CD38 protein, human; D051997:ADP-ribosyl Cyclase 1