A single measurement of CD38CD8 cells in HIV+, long-term surviving injecting drug users distinguishes those who will progress to AIDS from those who will remain stable

Abstract

SUMMARYThis study compares the predictive power of a single measurement of CD8 1 CD38 1 , CD81CD45RO 1 or CD8 1 CD38 1 CD45RO 1 subpopulations in predicting progression to AIDS in a cohort of HIV 1 longterm surviving injecting drug users. The results showed that both the total CD8 1 percentage, and the CD8 1 CD38 1 and CD8 1 CD38 1 CD45RO 1 subpopulations of cells all individually predicted progression to AIDS. In combination with CD4, only the CD8 1 CD38 1 subpopulation enhanced the predictive power of the CD4 percentage alone. The CD8 1 percentage correlated negatively with the CD4 percentage and the CD8 1 CD45RO 1 subpopulation did not predict disease progression. The proportion of CD8 1 CD38 1 cells identified which patients with a moderate CD4 level were more likely to progress to AIDS, and conversely, which patients with a low CD4 count were likely to remain clinically stable. The results were consistent irrespective of whether time was measured from the date of seroconversion, or from the date of the test. This study is the first to measure these markers in HIV-infected injecting drug users, and in long-term survivors. The results demonstrate the considerable added value of the CD8 1 CD38 1 cell percentage over the CD4 count alone, in predicting HIV clinical progression.

Correlates of Immune Activation Marker Changes in Human Immunodeficiency Virus (HIV)–Seropositive and High‐Risk HIV‐Seronegative Women Who Use Illicit Drugs

“…Quantitative expression of CD38 on CD8 cells has been demonstrated to be a marker of disease progression independent of HIV-1 RNA level [8]. The quantitative measurement of CD38 on CD8 cells also has been shown to add additional predictive power to clinical outcome in subjects with low CD4 cell counts [28]. The current study suggests that the quantitative measurement of CD38/DR on CD8 cells may be a valuable monitoring tool in subjects receiving antiretroviral therapy.…”

“…P ! .05 levels, especially on CD8 T cells and disease progression [26][27][28]. Quantitative expression of CD38 on CD8 cells has been demonstrated to be a marker of disease progression independent of HIV-1 RNA level [8].…”

A Low Level of CD4+CD28+T Cells Is an Independent Predictor of High Mortality in Human Immunodeficiency Virus Type 1–Infected Patients

“…A direct association could be explained by an impaired T cell response in CD4 + CD28 Ϫ cells resulting in accelerated loss of CD4 + cells and a poor clinical outcome. An indirect association could be explained by increased expression of activation markers (CD38, HLA-DR, or CD95) on CD28 Ϫ cells [14,[29][30][31], which is associated with a poor clinical outcome in HIV-1-infected patients [19][20][21][22][23][24][25].…”

“…Furthermore, the CD4 + CD28 + cell level correlates negatively with various HIV disease progression markers [4]. The CD4 + CD45RA + cell level has been shown to predict death independent of the total CD4 + cell count [6] and high levels of CD38 + T cells or expression of CD38 on T cells was recently shown to predict fast progression to AIDS [19][20][21][22][23], loss of CD4 + cells [24,25], and death [22].…”

“…Several studies have investigated the association between specific T cell phenotypes and progression to AIDS [3,[19][20][21][22][23], whereas only few studies have investigated these T cell phenotypes and progression to death [6,22].…”