Pre-seroconversion immune status predicts the rate of CD4 T cell decline following HIV infection.
OBJECTIVE
To study whether immune status prior to HIV seroconversion predicts CD4 T cell decline during HIV infection.


METHODS
Prospective cohort study including 51 injecting drug users (IDU) who were HIV negative at study entry and seroconverted for HIV during follow-up.


METHODS
Cryopreserved peripheral blood mononuclear cells obtained before HIV seroconversion were used to measure naive (CD45RO-CD27+), memory (CD45RO+CD27+), and total CD4 T cell numbers, the fraction of dividing Ki67+CD4+ T cells, and CD4 T cell receptor excision circles (TREC). The effect of pre-seroconversion immune status, as defined by these markers, on the rate of CD4 T cell decline during HIV infection was assessed using linear regression for repeated measurements.


RESULTS
IDU with low pre-seroconversion CD4 T cell TREC contents lost CD4 T cells at a significantly faster rate during HIV infection than those with a high CD4 T cell TREC content. IDU with higher pre-seroconversion CD4 T cell numbers had a significantly steeper CD4 T cell decline in the first 3 months of HIV infection, but their CD4 T cell counts remained higher throughout HIV infection. Intermediate levels of pre-seroconversion dividing Ki67+CD4+ T cells were associated with a significantly steeper CD4 cell decline than high levels. IDU with the highest pre-seroconversion drug-injecting frequencies showed slower CD4 T cell decline than those who injected less. No correlation was present between pre-seroconversion immune markers and the pre-seroconversion duration or intensity of drug use.


CONCLUSIONS
Among IDU, immune status prior to HIV infection as measured by TREC content affects the disease course after HIV seroconversion.
van Asten
Liselotte
L
Municipal Health Service, Sanquin Research at CLB and Academic Medical Centre and the Department of Human Retrovirology, Academic Medical Centre, Amsterdam, the Netherlands.
Danisman
Figen
F
Otto
Sigrid A
SA
Borghans
José A M
JA
Hazenberg
Mette D
MD
Coutinho
Roel A
RA
Prins
Maria
M
Miedema
Frank
F
D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology*; D006679:HIV Seropositivity / Q000276:immunology; D006801:Humans; D019394:Ki-67 Antigen / Q000276:immunology; D008297:Male; D011446:Prospective Studies; D011948:Receptors, Antigen, T-Cell / Q000276:immunology; D019966:Substance-Related Disorders / Q000150:complications / Q000276:immunology; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000276:immunology*
D019394:Ki-67 Antigen; D011948:Receptors, Antigen, T-Cell