Although generalized T-cell activation is an important factor in chronic HIV disease pathogenesis, its role in primary infection remains poorly defined. To investigate the effect of immune activation on T-cell changes in subjects with early HIV infection, and to test the hypothesis that an immunologic activation "set point" is established early in the natural history of HIV disease, a prospective cohort of acutely infected adults was performed. The median density of CD38 molecules on CD4 ؉ and CD8 ؉ T cells was measured longitudinally in 68 antiretroviral-untreated individuals and 83 antiretroviraltreated individuals. At study entry, T-cell activation was positively associated with viremia, with CD8 ؉ T-cell activation levels increasing exponentially at plasma HIV RNA levels more than 10 000 copies/mL. Among untreated patients, the level of CD8 ؉ T-cell activation varied widely among individuals but often remained stable within a given individual. CD8 ؉ T-cell activation and plasma HIV RNA levels over time were independently associated with the rate of CD4 ؉ T-cell loss in untreated individuals. These data indicate that immunologic activation set point is established early in HIV infection, and that this set point determines the rate at which CD4 ؉ T cells are lost over time. IntroductionUntreated HIV-1 infection is associated with a gradual loss of peripheral CD4 ϩ T cells. Although the direct cytopathic effect of HIV-1 on CD4 ϩ T cells almost certainly contributes to this gradual depletion, 1 most cells destined to die in vivo as a consequence of HIV infection are not productively infected with HIV. 2 This observation has led to the hypothesis that progressive CD4 ϩ T-cell depletion occurs due to indirect effects of viral replication. [3][4][5][6] The mechanism for these indirect effects of HIV replication on CD4 ϩ T-cell depletion is not understood.One widely accepted model postulates that HIV causes accelerated proliferation, expansion, and death of T cells, and that this heightened T-cell turnover eventually results in depletion or exhaustion of the regenerative capacity of the immune system. 4,5 Multiple studies have shown that HIV infection results in a state of high T-cell turnover (ie, the rates of T-cell proliferation and death are increased). For example, in vivo labeling of T cells indicates that HIV infection results in increased numbers of rapidly cycling CD4 ϩ and CD8 ϩ T cells. 7,8 These cells are primarily of memoryeffector phenotype, and are destined to proliferate and die rapidly. 9 The rate at which HIV recruits cells into this rapid turnover state is directly proportional to the level of viremia, 8 which in turn is directly related to the rate at which CD4 ϩ T cells are lost. 10 In the absence of antiretroviral treatment, markers of T-cell activation and T-cell turnover predict the rate of disease progression 11-14 and the rate of CD4 ϩ T-cell loss. 15 When antiretroviral therapy is initiated, the rate of T-cell turnover and the degree of generalized T-cell activation both decrease, suggest...

Lymphocytes bearing the CD8 marker were shown to suppress replication of human immunodeficiency virus (HIV) in peripheral blood mononuclear cells. The effect was dose-dependent and most apparent with autologous lymphocytes; it did not appear to be mediated by a cytotoxic response. This suppression of HIV replication could be demonstrated by the addition of CD8+ cells at the initiation of virus production as well as after several weeks of virus replication by cultured cells. The observations suggest a potential approach to therapy in which autologous CD8 lymphocytes could be administered to individuals to inhibit HIV replication and perhaps progression of disease.

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Infectious retroviruses have been detected in 22 of 45 randomly selected patients with acquired immune deficiency syndrome (AIDS) and in other individuals from San Francisco. The AIDS-associated retroviruses (ARV) studied in detail had a type D morphology, Mg2+-dependent reverse transcriptase, and cytopathic effects on lymphocytes. The viruses can be propagated in an established adult human T cell line, HUT-78. They cross-react with antiserum to the lymphadenopathy-associated retrovirus isolated from AIDS patients in France. Antibodies to ARV were found in all 86 AIDS patients and in a high percentage of 88 other homosexual men in San Francisco. This observation indicates the widespread presence of these lymphocytopathic retroviruses and their close association with AIDS.

Individuals infected with the human immunodeficiency virus type 1 (HIV-1) may be asymptomatic or have AIDS-related complex or the acquired immuno deficiency syndrome (AIDS). Little is known about the factors that influence progression of infection to AIDS. In this study of isolates of HIV-1 obtained at intervals during the infection of four individuals, the development of disease was found to be correlated with the emergence of HIV-1 variants that were more cytopathic in vitro as the disease progressed and that replicated more efficiently in a wide variety of different human cells. The biologic properties of HIV-1 in vitro thus appear to reflect its virulence in the host. Further studies of such sequentially isolated viruses may lead to the identification of viral genes that govern pathogenesis.

Strains of human immunodeficiency virus type 1 (HIV-1) display a high degree of biological heterogeneity which may be linked to certain clinical manifestation of AIDS. They vary in their ability to infect different cell types, to replicate rapidly and to high titre in culture, to down-modulate the CD4 receptor, and to cause cytopathic changes in infected cells. Some of these in vitro properties correlate with pathogenicity of the virus in vivo. To map the viral determinants of the cellular host range of HIV-1, recombinant viruses were generated between biologically active molecular clones of HIV-1 isolates showing differences in infection of primary peripheral blood macrophages and established T-cell lines. We report here that a specific region of the envelope gp120 gene representing 159 amino-acid residues of glycoprotein gp120 seems to determine macrophage tropism, whereas an overlapping region representing 321 amino-acid residues determines T cell-line tropism. These studies provide a basis for relating functional domains of the HIV-1 env gene to pathogenic potential.

IntroductionA progressive reduction in CD4 ϩ T-helper lymphocytes is the main feature of HIV infection and leads to a depression in adaptive immunity. 1 Innate immunity is also important in the host response to HIV infection and can be impaired during the course of this infection. Dendritic cells (DCs) can promote HIV transmission, [2][3][4][5] and DC function 6 and number 7 decline with HIV infection. The effector functions of monocytes and macrophages, including phagocytosis and intracellular oxidative responses, can be found decreased in HIV-infected subjects 8,9 and in cultured cells in the presence of HIV. [10][11][12][13] Superoxide production by neutrophils 14 as well as natural killer cell function as measured by the lymphokineactivated killer activity and responsiveness to interferon-␣ (IFN-␣) 15,16 have been shown to be defective in HIV-infected subjects.An important part of the innate defense against virus is the production of the type I IFNs, IFN-␣, and IFN-␤. 17 IFN-␣/␤ not only directly inhibit HIV replication, 18-20 but also have important adjuvant effects on a variety of immune cell types, such as monocytes, natural killer cells, 21 and T cells. [22][23][24][25][26] The in vitro type I IFN production by total peripheral blood mononuclear cells (PBMCs) was shown to be impaired during the course of HIV infection, and this impairment was associated with the occurrence of opportunistic infections. 27,28 CD4 ϩ CD11c Ϫ lineage marker Ϫ type 2 DC precursors (pre-DC2) were recently shown to be the natural IFN-␣/␤-producing cells in human blood. 29,30 IPCs produce up to 1000 times more IFN-␣ than any other blood cell type in response to viral stimulation. 29 Whether this impairment of IFN-␣/␤ production in HIV-infected individuals is due to a functional defect or to a reduction in number of IPCs is not known.In this study, we show that blood IPCs are severely decreased in AIDS patients but increased in asymptomatic long-term survivors (LTSs). The drop in IPC number and a decrease in their induced IFN production are associated with the presence of opportunistic infections and active Kaposi sarcoma. Our findings bring a new insight into the physiopathology of HIV infection and identify the IPC count as a new parameter to monitor the status of the immune system of HIV-infected subjects. Patients, materials, and methods HIV-infected subjectsFifty-four HIV-infected subjects were recruited from 3 centers: the University of California at San Francisco (UCSF), the San Francisco General Hospital, and the Hospices Civils de Lyon, France. This study was approved by the Committee for Human Research, UCSF. Subjects were enrolled consecutively, and the only inclusion criterion was a confirmed HIVpositive serology and a written informed consent. The following conditions, which can nonspecifically affect blood cell counts, were used as exclusion criteria: previous cytotoxic chemotherapy, splenectomy, hypersplenism, and blood transfusion within the past 4 weeks. After inclusion, a full medical history was taken and physic...

The nucleotide sequence of molecular clones of DNA from a retrovirus, ARV-2, associated with the acquired immune deficiency syndrome (AIDS) was determined. Proviral DNA of ARV-2 (9737 base pairs) has long terminal repeat structures (636 base pairs) and long open reading frames encoding gag (506 codons), pol (1003 codons), and env (863 codons) genes. Two additional open reading frames were identified. Significant amino acid homology with several other retroviruses was noted in the predicted product of gag and pol, but ARV-2 was as closely related to murine and avian retroviruses as it was to human T-cell leukemia viruses (HTLV-I and HTLV-II). By means of an SV-40 vector in transfected simian cells, the cloned gag and env genes of ARV-2 were shown to express viral proteins.