The typical course of HIV infection for a majority of untreated individuals is persistent viral replication and a gradual loss of CD4 + T cells. One of the consequences of ongoing HIV replication is increased immune activation, aff ecting all major cell populations of the immune system ( 1 -3 ). Within the B cell population, HIV infection has been associated with numerous perturbations ( 4 ), many of which have been attributed to changes in the distribution of B cell subpopulations found in the peripheral blood. These changes include increased frequencies of activated and terminally diff erentiated B cells expressing low levels of CD21 that have been associated with ongoing viral replication ( 5, 6 ), a decreased frequency of memory B cells that is not reversed by antiretroviral therapy ( 7 ), and an increased frequency of immature/transitional B cells that has been associated with CD4 + T cell lymphopenia ( 8, 9 ).The eff ects of immune activation in persistent viral infections have recently been shown to include virus-specifi c T cell exhaustion. After the original description in chronic lymphocyte choriomeningitis virus (LCMV) infection in mice ( 10 ), observations of virus-specifi c CD4 + and CD8 + T cell exhaustion have recently been extended to 12 ). Although PD-1 was the fi rst inhibitory receptor associated with virus-specifi c T cell exhaustion, recent fi ndings suggest that exhaustion may result

SUMMARY Virus-specific CD8+ T cells probably mediate control over HIV replication in rare individuals, termed long-term nonprogressors (LTNPs) or elite controllers. Despite extensive investigation, the mechanisms responsible for this control remain incompletely understood. We observed that HIV-specific CD8+ T cells of LTNPs persisted at higher frequencies than those of treated progressors with equally low amounts of HIV. Measured on a per-cell basis, HIV-specific CD8+ T cells of LTNPs efficiently eliminated primary autologous HIV-infected CD4+ T cells. This function required lytic granule loading of effectors and delivery of granzyme B to target cells. Defective cytotoxicity of progressor effectors could be restored after treatment with phorbol ester and calcium ionophore. These results establish an effector function and mechanism that clearly segregate with immunologic control of HIV. They also demonstrate that lytic granule contents of memory cells are a critical determinant of cytotoxicity that must be induced for maximal per-cell killing capacity.

The programmed death (PD)-1 molecule and its ligands (PD-L1 and PD-L2), negative regulatory members of the B7 family, play an important role in peripheral tolerance. Previous studies have demonstrated that PD-1 is up-regulated on T cells following TCR-mediated activation; however, little is known regarding PD-1 and Ag-independent, cytokine-induced T cell activation. The common gamma-chain (gamma c) cytokines IL-2, IL-7, IL-15, and IL-21, which play an important role in peripheral T cell expansion and survival, were found to up-regulate PD-1 and, with the exception of IL-21, PD-L1 on purified T cells in vitro. This effect was most prominent on memory T cells. Furthermore, these cytokines induced, indirectly, the expression of PD-L1 and PD-L2 on monocytes/macrophages in PBMC. The in vivo correlate of these observations was confirmed on PBMC isolated from HIV-infected individuals receiving IL-2 immunotherapy. Exposure of gamma c cytokine pretreated T cells to PD-1 ligand-IgG had no effect on STAT5 activation, T cell proliferation, or survival driven by gamma c cytokines. However, PD-1 ligand-IgG dramatically inhibited anti-CD3/CD28-driven proliferation and Lck activation. Furthermore, following restimulation with anti-CD3/CD28, cytokine secretion by both gamma c cytokine and anti-CD3/CD28 pretreated T cells was suppressed. These data suggest that gamma c cytokine-induced PD-1 does not interfere with cytokine-driven peripheral T cell expansion/survival, but may act to suppress certain effector functions of cytokine-stimulated cells upon TCR engagement, thereby minimizing immune-mediated damage to the host.