Shorter survival in advanced human immunodeficiency virus type 1 infection is more closely associated with T lymphocyte activation than with plasma virus burden or …

JV Giorgi, LE Hultin, JA McKeating… - The Journal of …, 1999 - academic.oup.com
JV Giorgi, LE Hultin, JA McKeating, TD Johnson, B Owens, LP Jacobson, R Shih, J Lewis…
The Journal of infectious diseases, 1999academic.oup.com
To define predictors of survival time in late human immunodeficiency virus type 1 (HIV-1)
disease, long-and short-duration survivors were studied after their CD4+ T cells fell to⩽
50/mm3. Immune activation of CD4+ and CD8+ T cells, as measured by elevated cell
surface expression of CD38 antigen, was strongly associated with shorter subsequent
survival (P⩾. 002). The naive CD45RA+ CD62L+ T cell reserve was low in all subjects and
did not predict survival (P=. 34 for. 34+ and. 08 for CD8+ cells). Higher virus burden …
Abstract
To define predictors of survival time in late human immunodeficiency virus type 1 (HIV-1) disease, long- and short-duration survivors were studied after their CD4+ T cells fell to ⩽50/mm3. Immune activation of CD4+ and CD8+ T cells, as measured by elevated cell surface expression of CD38 antigen, was strongly associated with shorter subsequent survival (P ⩾ .002). The naive CD45RA+CD62L+ T cell reserve was low in all subjects and did not predict survival (P = .34 for .34+ and .08 for CD8+ cells). Higher virus burden correlated with CD8+ but not CD4+ cell activation and, after correcting for multiple comparisons, was not associated with shorter survival (P = .02). All of the patients' viruses used CCR5, CXCR4, or both, and coreceptor usage did not predict survival (P = .27). Through mechanisms apparently unrelated to higher virus burden, immune activation is a major determinant of survival in advanced HIV-1 disease.
Oxford University Press