Prediction of Progression Rates
During the initial weeks after HIV infection, qualitative differences in the cell-mediated immune response are observed that correlate with different disease progression rates (i.e., rapid progression to WHO stage 4 and the rapid loss of CD4+ T cell levels versus normal to slow progression to WHO stage 4 and the maintenance of CD4+ T cell counts above 500/µl). The appearance of HIV-1-specific CD8+ cytotoxic T cells (CTLs) early after primo-infection has been correlated with the control of HIV-1 viremia. The virus which escapes this CTL response have been found to have mutations in specific CTL epitopes. Individuals with a broad expansion of the V-beta chain of the T cell receptor of CD8+ T cells during primo-infection appear seem to have low levels of virus six to twelve months later, which is predictive of relatively slow disease progression. In contrast, individuals with an expansion of only a single subset of the V-beta chain of the CD8+ T cells are not able to control HIV levels over time, and thus have high levels of virus six to twelve months later. LTNP’s have also been shown to have a vigorous proliferation of circulating activated HIV-1-specific CD4+ T cell and CTL response against multiple epitopes with no detectable broadly cross-reactive neutralizing antibodies in the setting of an extremely low viral load. However, a few reports have correlated the presence of antibodies against Tat in LTNP status.
Read more about this topic: HIV Disease Progression Rates
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