GAG-SPECIFIC CYTOTOXIC RESPONSES TO HIV TYPE-1 ARE ASSOCIATED WITH A DECREASED RISK OF PROGRESSION TO AIDS-RELATED COMPLEX OR AIDS

The duration of human immunodeficiency virus (HIV-1) infection prior to the development of AIDS is variable, and for most patients the exact time of infection is not known, A group of 38 HIV-1-infected subjects was tested while asymptomatic for comparative cytotoxic lymphocyte responses to the Gag and envelope antigens of HIV-1. Twenty of the 38 patients had no detectable primary cytotoxic T lymphocyte (CTL) response to Gag, and this was associated with a relative risk of 1.89 for progression to ARC or AIDS during the subsequent 3 to 40 months of observation when compared with patients who had Gag-specific CTL activity at the beginning of the observation period, In contrast, no significant association was observed between envelope-specific cytotoxic activity and disease progression, Other patient characteristics, including CD4(+) T lymphocyte counts and antibody levels to the p24(gag) protein, measured at the start of observation, did not correlate with disease progression during the observation period. This suggests that the anti-Gag CTL response may be protective during HIV-1 infection.