title: CD38 expression on CD8(+) T cells as a prognostic marker in vertically HIV-infected pediatric patients.
abstract: Increased expression of CD38 on CD8(+) T cells is associated with activation of the immune system, progression of HIV disease, and death in adults. The prognostic significance of these cells in HIV-infected children, where the picture is complicated by age-related differences in CD38 expression, remains controversial. Measuring the unimodal expression of CD38 on CD8(+) T cells in adults and children by flow cytometry is best accomplished by quantitating the antigen on the cell surface. To our knowledge, this technique has not previously been reported in a pediatric population. Vertically HIV-infected children were age matched for mild (n = 26) and severe (n = 23) clinical disease. Eleven age-matched HIV-negative controls were included for comparison. Quantitation of CD38 on CD8(+) T cells was performed at baseline and 1 y later. The ages of the children in the three clinical groups did not differ significantly (p = 0.6004). HIV-infected children had significantly increased CD38 measurements in comparison with the HIV-negative controls (p = 0.0131), and the severe disease group tended to have higher measurements than the mild disease group. Increased CD38(+)CD8(+) T cells were significant predictors of death within the first year (p = 0.043). These findings support the view that increased CD38 expression on CD8(+) T cells has the same prognostic significance in pediatric as in adult HIV disease.
authors.affiliation: Department of Haematology and Molecular Medicine, School of Pathology, South African Institute for Medical Research, Johannesburg, South Africa. gayles@mail.saimr.wits.ac.za
authors.forename: Gayle G
authors.initials: GG
authors.lastname: Sherman
authors.forename: Lesley E
authors.initials: LE
authors.lastname: Scott
authors.forename: Jacqueline S
authors.initials: JS
authors.lastname: Galpin
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
authors.forename: Caroline T
authors.initials: CT
authors.lastname: Tiemessen
authors.forename: Karen
authors.initials: K
authors.lastname: Simmank
authors.forename: Stephen
authors.initials: S
authors.lastname: Meddows-Taylor
authors.forename: Tamara M
authors.initials: TM
authors.lastname: Meyers
mesh_terms: D036541:ADP-ribosyl Cyclase; D051997:ADP-ribosyl Cyclase 1; D015703:Antigens, CD; D000943:Antigens, Differentiation / Q000032:analysis*; D015415:Biomarkers; D018414:CD8-Positive T-Lymphocytes / Q000737:chemistry*; D002648:Child; D002675:Child, Preschool; D005434:Flow Cytometry; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology* / Q000635:transmission; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008562:Membrane Glycoproteins; D009244:NAD+ Nucleosidase / Q000032:analysis*; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D015703:Antigens, CD; D000943:Antigens, Differentiation; D015415:Biomarkers; D008562:Membrane Glycoproteins; D036541:ADP-ribosyl Cyclase; C498154:CD38 protein, human; D009244:NAD+ Nucleosidase; D051997:ADP-ribosyl Cyclase 1