Loss of cytomegalovirus-specific CD4+T cell responses in human immunodeficiency virus type 1-infected patients with high CD4+T cell counts and recurrent retinitis

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Abstract

Clinical histories are reported for 2 patients treated with highly active antiretroviral therapy (HAART) who experienced multiple relapses of cytomegalovirus (CMV) retinitis, despite suppression of human immunodeficiency virus type 1 (HIV-1) viremia and improvement in CD4+T cell counts (to >400 cells/μL). CMV-specific CD4+T cell immune reconstitution was measured directly, using cytokine flow cytometry, which revealed persistent deficits in CMV-specific CD4+T cell responses in both patients. CMV-specific T cells constituted 0.14% and 0.05% of the total CD4+T cell count in these patients, which is significantly lower than the percentages for 34 control subjects (0.6%-46%; CD4+T cell count range, 7-1039 cells/μL; P = .019). Deficits in pathogen-specific immune responses may persist in some individuals, despite suppression of HIV-1 replication and substantial increases in circulating CD4+T cells after HAART, and such deficits may be associated with significant morbidity from opportunistic infections.

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Komanduri, K. V., Feinberg, J., Hutchins, R. K., Frame, R. D., Schmidt, D. K., Viswanathan, M. N., … McCune, J. M. (2001). Loss of cytomegalovirus-specific CD4+T cell responses in human immunodeficiency virus type 1-infected patients with high CD4+T cell counts and recurrent retinitis. Journal of Infectious Diseases, 183(8), 1285–1289. https://doi.org/10.1086/319683

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