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CD8 T cell persistence in treated HIV infection

Mudd, Joseph C.; Lederman, Michael M.

Current Opinion in HIV and AIDS: September 2014 - Volume 9 - Issue 5 - p 500–505
doi: 10.1097/COH.0000000000000086
CELL EXHAUSTION IN HIV-1 INFECTION: Edited by Daniel E. Kaufmann and Nabila Seddiki

Purpose of review Many treated HIV-infected persons maintain persistently high circulating CD8 T cell numbers, even after many years of therapy. Recent reports have suggested that persistent CD8 T cell expansion is associated with higher risk of morbid non-AIDS events. Thus, assessing the mechanisms of CD8 T cell expansion and persistence may give insights into a feature of HIV disease that is clinically important.

Recent findings Acute HIV infection is associated with activation and expansion of the CD8 T cell compartment. Expanded CD8 T cells persist throughout the disease course, and in contrast to the plasticity that typically characterizes immune responses to most other pathogens, circulating CD8 T cell numbers do not normalize in many patients despite pharmacologic suppression of HIV replication. We suspect that residual inflammation in treated HIV infection contributes to antigen-independent CD8 T cell expansion and persistence as most of these cells are not HIV-reactive.

Summary Circulating CD8 T cell numbers remain abnormally elevated in many treated HIV-infected patients and this elevation is associated with adverse clinical events. Future studies will be needed to assess the mechanisms of CD8 T cell expansion and to define the role of CD8 lymphocytosis in the clinical course of treated HIV disease.

Division of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

Correspondence to Michael M. Lederman, Division of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. Tel: +1 216 844 8786; e-mail: MXL6@case.edu

© 2014 Lippincott Williams & Wilkins, Inc.