The CD8+ T-cell response is central to control and eventual elimination of persistent viral infections. Although it might be expected that CD8+ T-cell activation would be associated with a better clinical outcome during viral infections, in long-term HIV-1 infection, high levels of CD8+ T-cell activation are instead associated with faster disease progression. In this study, cell surface expression of CD38, a flow cytometric marker of T-cell activation of CD8+ T cells, had predictive value for HIV-1 disease progression that was in part independent of the predictive value of plasma viral burden and CD4+ T-cell number. Measurements of CD38 antigen expression on CD8+ T cells in HIV-1-infected patients may be of value for assessing prognosis and the impact of therapeutic interventions. The pathogenetic reason why CD8+ T-cell activation is associated with poor outcome in HIV-1 disease remains unknown. Possibly CD8+ T-cell activation contributes to immunologic exhaustion, hyporesponsiveness of T cells to their cognate antigens, or perturbations in the T-cell receptor repertoire.
Address correspondence and reprint requests to Janis V. Giorgi, UCLA School of Medicine, Department of Medicine/Cellular Immunology and Cytometry, 12-236 Factor Building, Los Angeles, CA, 90095-1745, U.S.A.; email email@example.com.
Dr. Liu is currently affiliated with the New Jersey Department of Health and Senior Services, Division of Communicable Diseases, Trenton, New Jersey, U.S.A.
Manuscript received September 11, 1997; accepted January 26, 1998.
© Lippincott-Raven Publishers.