Shorter survival in advanced human immunodeficiency virus type 1 infection is more closely associated with T lymphocyte activation than with plasma virus burden or virus chemokine coreceptor usage

Janis V. Giorgi, Lance E. Hultin, Jane A. McKeating, Timothy D. Johnson, Bronwyn Owens, Lisa P. Jacobson, Roger Shih, Julie Lewis, Dorothy J. Wiley, John P. Phair, Steven M. Wolinsky, Roger Detels

Research output: Contribution to journalArticlepeer-review

Abstract

To define predictors of survival time in late human immunodeficiency virus type 1 (HIV-1) disease, long- and short-duration survivors were studied after their CD4+ T cells fell to ≤50/mm3. Immune activation of CD4+ and CD8+ T cells, as measured by elevated cell surface expression of CD38 antigen, was strongly associated with shorter subsequent survival (P ≤ .002). The naive CD45RA+CD62L+ T cell reserve was low in all subjects and did not predict survival (P = .34 for CD4+ and .08 for CD8+ cells). Higher virus burden correlated with CD8+ but not CD4+ cell activation and, after correcting for multiple comparisons, was not associated with shorter survival (P = .02). All of the patients' viruses used CCRS, CXCR4, or both, and coreceptor usage did not predict survival (P = .27). Through mechanisms apparently unrelated to higher virus burden, immune activation is a major determinant of survival in advanced HIV-1 disease.

Original languageEnglish (US)
Pages (from-to)859-870
Number of pages12
JournalJournal of Infectious Diseases
Volume179
Issue number4
DOIs
StatePublished - 1999
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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