CD4 AND CD8 LYMPHOCYTES IN DIAGNOSIS AND DISEASE PROGRESSION OF PEDIATRIC HIV-INFECTION

Vertical infection with human immunodeficiency virus-1 (HIV-I) causes profound changes in the proportions of subpopulations of lymphocytes i n the peripheral circulation. In this study the percentages in whole b lood of CD4 and CD8 cells, and of immunologically important subpopulat ions, were measured in 19 HIV-infected children over periods of up to 4 years and compared to our recently published ranges for normal child ren of various ages.(1) The rate of CD4 decline and of CD8 increase di ffered between clinically fast and slow progressors. On CD8 cells, cyt otoxic, memory (CD11a(bright) and CD45RO), and activation (HLA-DR) mar kers were raised soon after birth to levels outside the normal range, and compared favorably with HIV culture as a method for early diagnosi s of HIV infection. Mean levels of naive (CD45RA) and memory (CD45RO, CD29) markers on CD4 cells became significantly altered after 48 month s of age, suggesting that these are markers of more advanced disease. Despite different ages of enrollment into the study, in the cohort as a whole, the levels of the lymphocyte subpopulations studied changed c onsistently. Thus, their measurement could be useful both in the diagn osis and prognosis of HIV infection in individual children. This is th e first report showing that lymphocyte subpopulation analysis can play a major role in the diagnosis of pediatric HIV infection.