RAPID REEMERGENCE OF T-CELLS INTO PERIPHERAL-CIRCULATION FOLLOWING TREATMENT OF SEVERE AND UNCOMPLICATED PLASMODIUM-FALCIPARUM MALARIA

Frequencies and absolute numbers of peripheral T-cell subsets were mon itored closely following acute Plasmodinm falciparum malaria in 22 Gha naian children from an area of hyperendemicity for seasonal malaria tr ansmission. The children presented with cerebral or uncomplicated mala ria (CM or UM, respectively) or with severe malarial anemia. For all p atients the frequencies and absolute numbers of peripheral T cells wer e lower than normal during the acute stage of disease. This lowering w as most pronounced in the Chi group and least pronounced in the UM gro up. Of particular interest, the CM patients showed markedly reduced fr equencies of CD4(+) cells, the number of which also normalized slower than in the other clinical groups. In all patients, the T-cell frequen cies gradually approached normal values after the initiation of therap y, whereas the absolute numbers rapidly reverted from lower than norma l to higher than normal before returning to steady-state levels. Furth ermore, the initially reduced T-cell surface density of the T-cell rec eptor/CD3 complex, which rapidly normalized, was a general finding for all three clinical groups, suggesting a state of peripheral T-cell hy poresponsiveness during acute malaria. The data presented suggest a ra pid therapy-induced reemergence of T cells that had been temporarily r emoved from the peripheral circulation as a consequence of the malaria attack and that the degree of the disease-induced T-cell reallocation correlates with disease severity.