title: Pre-seroconversion immune status predicts the rate of CD4 T cell decline following HIV infection.
abstract: 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.
authors.affiliation: Municipal Health Service, Sanquin Research at CLB and Academic Medical Centre and the Department of Human Retrovirology, Academic Medical Centre, Amsterdam, the Netherlands.
authors.forename: Liselotte
authors.initials: L
authors.lastname: van Asten
authors.forename: Figen
authors.initials: F
authors.lastname: Danisman
authors.forename: Sigrid A
authors.initials: SA
authors.lastname: Otto
authors.forename: José A M
authors.initials: JA
authors.lastname: Borghans
authors.forename: Mette D
authors.initials: MD
authors.lastname: Hazenberg
authors.forename: Roel A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: Frank
authors.initials: F
authors.lastname: Miedema
mesh_terms: 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*
chemical_list: D019394:Ki-67 Antigen; D011948:Receptors, Antigen, T-Cell