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Blood, 1 September 2005, Vol. 106, No. 5, pp. 1660-1667.
Prepublished online as a Blood First Edition Paper on May 19, 2005; DOI 10.1182/blood-2005-01-0206.
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Submitted January 18, 2005
Accepted April 22, 2005
Early proliferation of CCR5+ CD38+++ antigen-specific CD4+ Th1 effector cells during primary HIV-1 infection
John J Zaunders*, Mee Ling Munier, Daniel E Kaufmann, Susanna Ip, Pat Grey, Don Smith, Tim Ramacciotti, Dick Quan, Robert Finlayson, John Kaldor, Eric S Rosenberg, Bruce D Walker, David A Cooper, and Anthony D Kelleher
Centre for Immunology, St. Vincent's Hospital, Sydney, NSW, Australia
Centre for Immunology, St. Vincent's Hospital, Sydney, NSW, Australia; National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW, Australia
Partners AIDS Research Center, Massachusetts General Hospital, Boston, MA, USA
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW, Australia
Holdsworth House General Practice, Sydney, NSW, Australia
Taylor Square Private Clinic, Sydney, NSW, Australia
* Corresponding author; email: j.zaunders{at}cfi.unsw.edu.au.
We investigated whether HIV-1 antigen-specific CD4+ T cells expressed the viral co-receptor, CCR5, during primary HIV-1 infection (PHI). In the peripheral blood of subjects with very early PHI (< 22 days post-onset of symptoms), there was a 10 to 20-fold increase in the proportion of highly activated (CD38+++) and proliferating (Ki-67+) CD4+ T cells which expressed CCR5+, and were mostly TIA-1+perforin+granzymeB+. In the same patient samples, CD4+ T cells producing IFN- in response to HIV Gag peptides were readily detected (median 0.58%) by intracellular cytokine assay - these cells were again predominantly CD38+++, Ki-67+ and TIA-1+, as well as Bcl-2low. On average, 20% of the Gag-specific CD4+ T cells also expressed IL-2 and were CD127(IL-7R)+. Taken together, these results suggest that Gag-specific Th1 effector cells express CCR5+ during the primary response and may include precursors of long-term self-renewing memory cells. However, in PHI subjects with later presentation, antigen-specific CD4+ T cells could not be readily detected (median 0.08%), coinciding with a 5-fold lower level of the CCR5+CD38+++ CD4+ T cells. These results suggest that the anti-viral response to HIV-1 infection includes highly activated CCR5+CD4+ cytotoxic effector cells, which are susceptible to both apoptosis and cytopathic infection with HIV-1, and rapidly decline.

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