Shorter survival in advanced human immunodeficiency virus type 1 infection is more closely associated with T lymphocyte activation than with plasma virus burden or virus chemokine coreceptor usage

Janis V. Giorgi*, Lance E. Hultin, Jane A. McKeating, Timothy D. Johnson, Bronwyn Owens, Lisa P. Jacobson, Roger Shih, Julie Lewis, Dorothy J. Wiley, John P. Phair, Steven M. Wolinsky, Roger Detels

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

831 Scopus citations

Abstract

To define predictors of survival time in late human immunodeficiency virus type 1 (HIV-1) disease, long- and short-duration survivors were studied after their CD4+ T cells fell to ≤50/mm3. Immune activation of CD4+ and CD8+ T cells, as measured by elevated cell surface expression of CD38 antigen, was strongly associated with shorter subsequent survival (P ≤ .002). The naive CD45RA+CD62L+ T cell reserve was low in all subjects and did not predict survival (P = .34 for CD4+ and .08 for CD8+ cells). Higher virus burden correlated with CD8+ but not CD4+ cell activation and, after correcting for multiple comparisons, was not associated with shorter survival (P = .02). All of the patients' viruses used CCRS, CXCR4, or both, and coreceptor usage did not predict survival (P = .27). Through mechanisms apparently unrelated to higher virus burden, immune activation is a major determinant of survival in advanced HIV-1 disease.

Original languageEnglish (US)
Pages (from-to)859-870
Number of pages12
JournalJournal of Infectious Diseases
Volume179
Issue number4
DOIs
StatePublished - 1999

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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