title: Kinetics of Gag-specific cytotoxic T lymphocyte responses during the clinical course of HIV-1 infection: a longitudinal analysis of rapid progressors and long-term asymptomatics.
abstract: To gain more insight into the role of HIV-1-specific cytotoxic T lymphocytes (CTL) in the pathogenesis of AIDS, we investigated temporal relations between HIV-1 Gag-specific precursor CTL (CTLp), HIV-1 viral load, CD4+ T cell counts, and T cell function. Six HIV-1-infected subjects, who were asymptomatic for more than 8 yr with CD4+ counts > 500 cells/mm3, were compared with six subjects who progressed to AIDS within 5 yr after HIV-1 seroconversion. In the long-term asymptomatics, persistent HIV-1 Gag-specific CTL responses and very low numbers of HIV-1-infected CD4+ T cells coincided with normal and stable CD4+ counts and preserved CD3 mAb-induced T cell reactivity for more than 8 yr. In five out of six rapid progressors Gag-specific CTLp were also detected. However, early in infection the number of circulating HIV-1-infected CD4+ T cells increased despite strong and mounting Gag-specific CTL responses. During subsequent clinical progression to AIDS, loss of Gag-specific CTLp coincided with precipitating CD4+ counts and severe deterioration of T cell function. The possible relationships of HIV-1 Gag-specific CTLp to disease progression are discussed.
authors.affiliation: Department of Clinical Viro-Immunology, Central Laboratory of The Netherlands Red Cross Blood Transfusion Service, Amsterdam.
authors.forename: M R
authors.initials: MR
authors.lastname: Klein
authors.forename: C A
authors.initials: CA
authors.lastname: van Baalen
authors.forename: A M
authors.initials: AM
authors.lastname: Holwerda
authors.forename: S R
authors.initials: SR
authors.lastname: Kerkhof Garde
authors.forename: R J
authors.initials: RJ
authors.lastname: Bende
authors.forename: I P
authors.initials: IP
authors.lastname: Keet
authors.forename: J K
authors.initials: JK
authors.lastname: Eeftinck-Schattenkerk
authors.forename: A D
authors.initials: AD
authors.lastname: Osterhaus
authors.forename: H
authors.initials: H
authors.lastname: Schuitemaker
authors.forename: F
authors.initials: F
authors.lastname: Miedema
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology; D000328:Adult; D018791:CD4 Lymphocyte Count; D003602:Cytotoxicity, Immunologic; D018450:Disease Progression; D015683:Gene Products, gag / Q000276:immunology*; D015658:HIV Infections / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007700:Kinetics; D008137:Longitudinal Studies; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*; D014766:Viremia / Q000276:immunology
chemical_list: D015683:Gene Products, gag