SOLUBLE VERSUS CELL-BOUND CD4, CD8 FROM BRONCHOALVEOLAR LAVAGE - CORRELATION WITH PULMONARY DIAGNOSES IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED INDIVIDUALS

Identification and assessment of cell populations in bronchoalveolar l avage (BAL) specimens may be used to follow the course of a disease st ate or response to specific therapy, Beyond cellular assessment, there are indications that the presence and quantity of soluble surface ant igens released from activated cells may lead to improved understanding and facilitated diagnosis of a number of disease states. This study e valuated soluble markers (sCD4 and sCD8) in BAL and serum from HIV-inf ected individuals undergoing diagnostic bronchoscopy,and compared thes e values to flow cytometry-quantified BAL and peripheral blood cell CD 4 and CD8. Patient pulmonary diagnosis (based on cytology and microbio logy) was compared with patient blood and BAL-soluble and cell-bound C D4 and CD8 to determine the relationship of these markers to disease s tates in this population, Serum sCD8 in patients with fungal infection s was significantly elevated above sCD8 in patients with Pneumocystis carinii or pulmonary bacterial infections, p = 0.0001, BAL sCD4/sCD8 r atio was also significantly different in patients with bacterial vs, f ungal pulmonary infections, p = 0.01. These findings suggest that solu ble markers, particularly elevated sCD8, may be an important indicatio n of pulmonary disease progression in these HIV+ patients with fungal infections.