GAG-SPECIFIC CYTOTOXIC RESPONSES TO HIV TYPE-1 ARE ASSOCIATED WITH A DECREASED RISK OF PROGRESSION TO AIDS-RELATED COMPLEX OR AIDS

The duration of human immunodeficiency virus (HIV-1) infection prior t o the development of AIDS is variable, and for most patients the exact time of infection is not known, A group of 38 HIV-1-infected subjects was tested while asymptomatic for comparative cytotoxic lymphocyte re sponses to the Gag and envelope antigens of HIV-1. Twenty of the 38 pa tients had no detectable primary cytotoxic T lymphocyte (CTL) response to Gag, and this was associated with a relative risk of 1.89 for prog ression to ARC or AIDS during the subsequent 3 to 40 months of observa tion when compared with patients who had Gag-specific CTL activity at the beginning of the observation period, In contrast, no significant a ssociation was observed between envelope-specific cytotoxic activity a nd disease progression, Other patient characteristics, including CD4() T lymphocyte counts and antibody levels to the p24(gag) protein, mea sured at the start of observation, did not correlate with disease prog ression during the observation period. This suggests that the anti-Gag CTL response may be protective during HIV-1 infection.