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Blood, 15 August 2004, Vol. 104, No. 4, pp. 942-947.
Prepublished online as a Blood First Edition Paper on April 29, 2004; DOI 10.1182/blood-2003-09-3333.
Previous Article | Next Article 
Submitted October 2, 2003
Accepted February 17, 2004
Immune Activation Set-point During Early HIV Infection Predicts Subsequent CD4+ T Cell Changes Independent of Viral Load
Steven G Deeks*, Cristina M Kitchen, Lea Liu, Hua Guo, Ron Gascon, Amy B Narvaez, Peter Hunt, Jeffrey N Martin, James O Kahn, Jay Levy, Michael S McGrath, and Frederick M Hecht
Department of Medicine, University of California, San Francisco, CA, USA
Department of Biostatistics, School of Public Health, University of California, Los Angeles, CA, USA
* Corresponding author; email: sdeeks{at}php.ucsf.edu.
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 antiretroviral-treated individuals. At study entry, T cell activation was positively association with viremia, with CD8+ T cell activation levels increasing exponentially at plasma HIV RNA levels greater than 10,000 copies/mL. Among untreated patients, the level of CD8+ T cell activation varied widely between 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 HIV infection, and that this set-point determines the rate at which CD4+ T cells are lost over time.

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