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Blood, Vol. 92 No. 9 (November 1), 1998:
pp. 3105-3114
Virological and Immunological Features of Long-Term Human
Immunodeficiency Virus-Infected Individuals Who Have Remained
Asymptomatic Compared With Those Who Have Progressed to Acquired
Immunodeficiency Syndrome
Edward Barker,
Carl E. Mackewicz,
Gustavo Reyes-Terán,
Akihiko Sato,
Sharon A. Stranford,
Sue H. Fujimura,
Cindy Christopherson,
Sheng-Yung Chang, and
Jay A. Levy
From the Department of Medicine, University of California, San
Francisco; Departamento de Investigacion en Microbiologia, Instituto
Nacional de Enfermeda des Respiratorias, Colonia Seccion, Mexico City,
Mexico; Shionogi Institute for Medical Science, Osaka,
Japan; and Roche Molecular Systems Inc, Alameda, CA.
Infection with the human immunodeficiency virus (HIV) leads to a
decrease in CD4+ T cells and disease progression within a
decade of seroconversion. However, a small group of infected people,
despite being infected by HIV for 10 or more years, remain clinically
asymptomatic and have stable CD4+ cell counts without
taking antiretroviral medication. To determine why these individuals,
known as long-term survivors (LTS), remain healthy, the hematological
profiles, viral load and properties, HIV coreceptor genotype, and
anti-HIV immune responses of these people were compared with those of
individuals who have progressed to disease (Progressors) over the same
time period. Unlike Progressors, LTS have a low circulating viral load
and a low number of HIV-infected cells. These differences in the levels
of the viral load were not associated with a dominant biologic viral
phenotype, varying growth kinetics of the virus, mutation in the
cellular CCR5 gene, or the presence of neutralizing antibodies.
Importantly, the difference in viral load could be explained by the
enhanced ability of CD8+ cells from LTS to suppress HIV
replication.
© 1998 by The American Society of Hematology.
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