HIGH SERUM LEVEL OF THE SOLUBLE FORM OF CD30 MOLECULE IN THE EARLY PHASE OF HIV-1 INFECTION AS AN INDEPENDENT PREDICTOR OF PROGRESSION TO AIDS

Objective: To determine the serum levels of the soluble form of the CD 30 (sCD30) activation molecule in the early phase of HIV-1 infection, and to investigate the possible correlation with evolution to AIDS. Me thods: sCD30 values were determined by an enzyme-linked immunosorbent assay (ELISA) on serum samples collected at the time of the first evid ence of HIV-1 infection in 110 individuals with a median follow-up of 56 months (range, 12-88 months), at the A1 (74 cases) or A2 (36 cases) stages of the 1993 revised Centers for Disease Control and Prevention classification. The data were evaluated using established clinical an d immunological parameters, including circulating CD4+ T-cell count. T he controls were 110 blood donors and 51 HIV-1-negative subjects belon ging to groups at risk for HIV-1 infection. Results: Elevated sCD30 le vels (> 20 U/ml) were found in 83.6% of HIV-1-infected cases and in 47 % of at-risk seronegatives. Data analysis revealed that HIV-1-infected patients with higher sCD30 levels (> 35 U/ml) experienced faster dise ase progression (P=0.0002). Th is was also the case in patients at the earliest stage (A1) of HIV infection (P=0.0027). In these latter case s the predictive value of sCD30 was independent of the initial absolut e number of circulating CD4+ lymphocytes. Conclusions: Serum levels of sCD30 are increased in the large majority of patients in the early ph ase of HIV-1 infection and represent an indicator of progression to AI DS independent of other prognostic parameters.