Jjj. Maas et al., Strong association between failure of T cell homeostasis and the syncytium-inducing phenotype among HIV-1-infected men in the Amsterdam Cohort Study, AIDS, 14(9), 2000, pp. 1155-1161
Objective: To assess the association between T cell homeostasis and its fai
lure and 1.) the occurence of AIDS and 2.1 the switch from the non-syncytiu
m-inducing (NSI) to the syncytium-inducing (S1) HIV virus phenotype.
Methods: For each of 325 homosexual men in the Amsterdam Cohort Study, the
slope of the CD3 T cell count versus time was determined. The timing (T cel
l inflection point (IP)) and magnitude of the change in slope were correlat
ed with the time of the NSI/SI switch.
Results: Median T cell slopes before the IP (pre-IP) were nearly zero regar
dless of whether AIDS occurred; the slopes after the IP (post-IP) were asso
ciated with clinical outcomes, with a median annual decline of 17.6% among
those who developed AIDS and increase of 4.6% in those remaining AIDS free.
Among subjects considered to have a true IP (decline > 8.2%/year post-IP),
the times of the SI switch and the IP slope were highly correlated (r = 0.
65); among those with AIDS, the S1 switch preceded the IP by a median of 0.
63 years.
Conclusion: These results support the concept of blind T cell homeostasis a
nd also suggest that HIV-1 SI variants play an important role in the failur
e of T cell homeostasis. (C) 2000 Lippincott Williams & Wilkins.