A low level of CD4+CD28+ T cells is an independent predictor of high mortality in human immunodeficiency virus type 1-infected patients.
This study investigated coexpression of CD28, CD45RA, and CD45RO on CD4(+) and CD8(+) cells in 107 human immunodeficiency virus (HIV) type 1-infected patients, who were followed-up prospectively and were not treated with highly active antiretroviral therapy, and 65 control subjects. The most important novel finding was that a 50% reduction in CD4(+)CD28(+) cells predicted increased mortality (relative hazards [HR], 1.6; 95% confidence interval [CI], 1.0-2.6; P=.04), even after adjusting for the CD4(+) cell counts, virus load, beta(2)-microglobulin and hemoglobin levels, and HIV disease stage. Patients with progressed HIV infection had decreased concentrations of all studied cell subsets. Concerning the proportions of cells, only CD4(+)CD28(+), CD4(+)CD45RA(+), and CD8(+)CD45RO(+) cells decreased with HIV progression. Low proportions of CD4(+)CD45RA(+), CD8(+)CD45RA(+), and CD8(+)CD45RO(+) cells predicted mortality only in univariate but not in multivariate Cox analyses. If our results are confirmed in other studies, coexpression of CD28 on CD4(+) cells may be a useful marker to evaluate HIV progression.
Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. sis@dadlnet.dk
Sisse R
SR
Ostrowski
Jan
J
Gerstoft
Bente K
BK
Pedersen
Henrik
H
Ullum
D000328:Adult; D018106:CD28 Antigens / Q000032:analysis / Q000276:immunology*; D015704:CD4 Antigens / Q000032:analysis / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality* / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype; D016019:Survival Analysis; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D019562:Viral Load
D018106:CD28 Antigens; D015704:CD4 Antigens