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Prepublished online as a Blood First Edition Paper on August 22, 2002; DOI 10.1182/blood-2002-03-0791.

Submitted March 13, 2002
Accepted August 7, 2002
Most antiviral CD8 T cells during chronic viral infection do not express high levels of perforin and are not directly cytotoxic
Dong Zhang, Premlata Shankar, Zhan Xu, Brooke Harnisch, Gang Chen, Christoph Lange, Sandra J Lee, Hernan Valdez, Michael M Lederman, and Judy Lieberman*
Center for Blood Research Medicine, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Center for Blood Research Medicine, Boston, MA, USA
Center for AIDS Research, University Hospitals of Cleveland, Cleveland, OH, USA
Department of Biostatistical Science, Dana Farber Cancer Institute, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
* Corresponding author; email: lieberman{at}cbr.med.harvard.edu.
Despite the frequency of HIV-specific CD8 T cells, most HIV-infected patients do not control viral replication without antiviral drugs. Although CD8 T cells are important in containing acute HIV and SIV infection, CD8 T cell functions are compromised in chronic infection. To investigate whether functional deficits are specific to HIV, the phenotypic and functional properties of HIV, EBV and CMV-specific CD8 T cells, labeled with A2.1 or B8 tetramers, were compared in 35 HIV-infected and 9 normal donors. Cytotoxic T lymphocytes express cytolytic molecules, perforin and granzymes, and are thought to be CD45RA+CD27-. Although most HIV-specific cells are antigen-experienced and express granzyme A (median 85%), few express perforin (median 10%) or CD45RA (median 14%) or have down-modulated CD27 (median 12%). Perforin expression by HIV-specific cells is not significantly different from that of EBV or CMV-specific cells in the same donors or in normal donors. EBV and CMV-specific cells, like HIV-specific cells, are often not cytotoxic when tested directly ex vivo. HIV-specific T cell expression of other phenotypic markers is similar to that of EBV and CMV-specific CD8 T cells in normal donors. However, CMV-specific cells (and to a lesser extent EBV-specific cells) in HIV-infected donors are more likely to be CD27-, CD45RA+, and GzmA+. These results suggest that the chance to eradicate an infection by T cell mediated lysis may be undermined once an infection becomes chronic. Impaired antiviral cytotoxicity during chronic infection is not specific to HIV, but likely represents the immune response to chronic antigenic exposure.

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