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Blood, 15 February 2006, Vol. 107, No. 4, pp. 1427-1433.
Prepublished online as a Blood First Edition Paper on October 18, 2005; DOI 10.1182/blood-2005-07-2907.
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Submitted July 20, 2005
Accepted September 29, 2005
Prognostic value of HIV-1 Gag-specific CD4+ T-cell responses for progression to AIDS analysed in a prospective cohort study
Christine A Jansen, Iris M De Cuyper, Berend Hooibrink, Akke K van der Bij, Debbie van Baarle, and Frank Miedema*
Department of Clinical Viro-Immunology, Sanquin Research and Landsteiner Laboratory of the Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Immunology, University Medical Center, Utrecht, The Netherlands
Department of Clinical Viro-Immunology, Sanquin Research and Landsteiner Laboratory of the Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Department of HIV&STI Research, Cluster of Infectious Diseases, Municipal Health Service, University of Amsterdam, Amsterdam, The Netherlands
* Corresponding author; email: f.miedema{at}umcutrecht.nl.
The causal relationship between HIV-specific CD4+ T-cell responses and viral control and the impact of these responses on the natural history of HIV infection is unclear.
In a detailed longitudinal study, functional HIV-1 Gag-specific CD4+ T cells were analysed in long-term asymptomatic individuals (LTA, n=6) and progressors to AIDS (n=7) with a median follow-up of respectively 118 and 57 months. Next, HIV-specific CD4+ T-helper cell responses were measured in a prospective cohort study among 96 HIV seroconverters and were related to clinical endpoints using Cox-proportional hazard analysis.
In the detailed study, no difference for HIV-specific helper cell responses between LTA and progressors was observed early in infection, but Gag-specific CD4+ T cells producing IL-2 or IFN were lost in progressors late in infection. Multivariate proportional hazard analyses in the prospective cohort study showed that HIV-specific IL-2+, IFN + or IL-2+IFN + CD4+ T cells early after seroconversion had no prognostic value for the rate of progression to AIDS.
Our results are compatible with viral load determining the nature and magnitude of HIV-specific CD4+ T-cell responses, rather than HIV-specific CD4+ T-cell responses controlling HIV plasma viral load.

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