title: HIV-specific CD4+ T cells and viremia: who's in control?
abstract: It has been proposed that HIV-specific CD4+ T cells with a central memory phenotype might be involved in controlling HIV replication. Based on recent data (lack of protective effects of HIV-specific CD4+ T-cell responses in acutely infected patients undergoing treatment interruptions; loss of initially strong T-helper cell responses in progressors to AIDS; and lack of prognostic value of HIV-specific CD4+ T cells in a prospective study) we argue that the level of persistent viremia determines the fate of HIV-specific CD4+ T cells. We postulate that, rather than the absence of HIV-specific T cells, it is the viral and immune activation set points that are major determinants of progression to AIDS. This influences ideas about the type of cellular immunity a protective HIV vaccine should induce.
authors.affiliation: Department of Clinical Viro-Immunology, Sanquin Research and Landsteiner Laboratory of the Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Jansen
authors.forename: Debbie
authors.initials: D
authors.lastname: van Baarle
authors.forename: Frank
authors.initials: F
authors.lastname: Miedema
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D015704:CD4 Antigens / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D002908:Chronic Disease; D000939:Epitopes; D015488:HIV Antigens / Q000276:immunology; D015658:HIV Infections / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D014766:Viremia / Q000276:immunology* / Q000821:virology
chemical_list: D015704:CD4 Antigens; D000939:Epitopes; D015488:HIV Antigens