CD8+ LYMPHOCYTE-ACTIVATION AT HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 SEROCONVERSION - DEVELOPMENT OF HLA-DR+ CD38- CD8+ CELLS IS ASSOCIATED WITH SUBSEQUENT STABLE CD4+ CELL LEVELS

Subsets of activated CD8(+) lymphocytes defined by membrane expression of the activation antigens HLA-DR and CD38 were counted by three-color flow cytometry in homosexual men who subsequently became seropositive for human immunodeficiency virus type 1 (HIV). Profound CD8(+) cell activation was seen in all subjects at seroconversion and 6 and 12 months later. The HLA-DR(+) CD38(+) CD8(+) cell population, which has potent direct HIV cytotoxic T cell activity, was markedly elevated at seroconversion in all subjects. In some men, these levels remained elevated throughout the first year of infection. During the next 5 years, these men had stable CD4(+) cell levels, whereas the others did not. Long-term survivors (seropositive for 9 years, > 800 CD4(+) cells/mm(3)) also had elevated levels of this subset, despite few other activated CD8(+) cells. Thus, selective elevation of HLA-DR(+) CD38(-) CD8(+) cells was a marker of subsequent stable HIV disease.