MASSIVE ACTIVATION OF IMMUNE CELLS WITH AN INTACT T-CELL REPERTOIRE IN ACUTE HUMAN-IMMUNODEFICIENCY-VIRUS SYNDROME

In 8 patients with symptomatic, acute primary infection with human imm unodeficiency virus (HIV), a dramatic and persistent decrease in CD4() lymphocytes was seen, accompanied by a marked increase in activated/ memory CD8(+) T cells (CD38(+), CD45R0(+), HLA-DR(+), with high amount s of cell adhesion molecules), which represented most circulating lymp hocytes, but no gross alterations in vp T cell repertoire. Extremely h igh plasma levels of proinflammatory cytokines were observed. Three pa tients were followed for 2-3 years: The number of CD4(+) cells, extrem ely low at first, increased significantly in a few months but decrease d rapidly after a short stable period. Cytotoxic T lymphocytes bearing markers of immunologic activation/memory could play an important role in the earliest phases of the disease. It remains to be established h ow such a dramatic onset could determine the rapid progression of the infection that seems characteristic of patients with acute HIV syndrom e.