ELEVATED RELATIVE FLUORESCENCE INTENSITY OF CD38 ANTIGEN EXPRESSION ON CD8(-CELLS IS A MARKER OF POOR-PROGNOSIS IN HIV-INFECTION - RESULTS OF 6 YEARS OF FOLLOW-UP() T)

Relative fluorescence intensity measurements from a flow cytometer wer e used to evaluate expression of CD38 and HLA-DR antigens. These molec ules are associated with cellular activation and are present at increa sed levels on the CD8(+) lymphocytes of HIV-infected subjects, In the current study, the prognostic value of mean fluorescence intensity mea surements of CD38 and HLA-DR on CD8(+) cells was compared to results f rom our previous study in which we reported prognostic value for an el evated percentage of CD8(+) cells that were positive for expression of the CD38 antigen (Giorgi et al.: JAIDS 6:904-912, 1993), Using the pr oportional hazards model, elevated mean fluorescence intensity of CD38 expression on 888 cells had prognostic value for development of AIDS that was almost identical to the prognostic value of the percentage of CD8(+) cells that were positive for expression of CD38. This prognost ic value was in addition to that provided by the patient's CD4(+) cell measurement, To our knowledge, this is the first report that a measur ement of fluorescence intensity can be used as a prognostic marker in an immunodeficiency disease. Efforts are needed to establish methods t hat will allow widespread application of this observation in the clini cal management of HIV-infected subjects. (C) 1996 Wiley-Liss, Inc.