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Journal of Acquired Immune Deficiency Syndromes:
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Patterns of CD4+ Cell Changes After HIV-1 Infection Indicate the Existence of a Codeterminant of AIDS.

Detels, Roger; English, Patricia A.; Giorgi, Janis V.; Visscher, Barbara R.; Fahey, John L.; Taylor, Jeremy M. G.; Dudley, Janice P.; Nishanian, Parunag; Muñoz, Alvaro; Phair, John P.; Polk, B. Frank; Rinaldo, Charles R.

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Successive interval slopes of CD4+ cells each constructed from levels at three consecutive 6 month visits were compared over 3 years of follow-up among 565 persistently HIV-1 antibody-positive, 326 persistently antibody-negative, and 51 seroconverting homosexual men who had at least 500 CD4+ cells/mm3 at baseline and completed the first three 6 month visits. "Change" was defined as a difference between two successive interval slopes. Sixty-two percent of sero converters meeting these criteria experienced a shift in one or more of their successive CD4+ interval slopes, the majority (56%) from a level slope to a negative slope (decreasing numbers of CD4+ cells), a significantly greater proportion than that observed among seronegatives (30%, p < 0.0001). Fifty-eight percent of the sero positives maintained level interval slopes over the 3 years of follow-up. The majority (59%) of those men experiencing a shift went from a level to a negative interval slope, a significantly greater proportion than observed among seronegatives (30%, p < 0.0001). The observed patterns of change in interval slopes are consistent with the laboratory observation that CD4+ cells must be activated to replicate HIV-1. The use of the interval slope strategy provides a method to identify a temporal focal point at which to examine possible codeterminants that trigger the production of HIV-1 and the subsequent decline in CD4+ cells.

(C) Lippincott-Raven Publishers.


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