Mudd Joseph C, Lederman Michael M
Division of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Curr Opin HIV AIDS. 2014 Sep;9(5):500-5. doi: 10.1097/COH.0000000000000086.
Many treated HIV-infected persons maintain persistently high circulating CD8 T cell numbers, even after many years of therapy. Recent reports have suggested that persistent CD8 T cell expansion is associated with higher risk of morbid non-AIDS events. Thus, assessing the mechanisms of CD8 T cell expansion and persistence may give insights into a feature of HIV disease that is clinically important.
Acute HIV infection is associated with activation and expansion of the CD8 T cell compartment. Expanded CD8 T cells persist throughout the disease course, and in contrast to the plasticity that typically characterizes immune responses to most other pathogens, circulating CD8 T cell numbers do not normalize in many patients despite pharmacologic suppression of HIV replication. We suspect that residual inflammation in treated HIV infection contributes to antigen-independent CD8 T cell expansion and persistence as most of these cells are not HIV-reactive.
Circulating CD8 T cell numbers remain abnormally elevated in many treated HIV-infected patients and this elevation is associated with adverse clinical events. Future studies will be needed to assess the mechanisms of CD8 T cell expansion and to define the role of CD8 lymphocytosis in the clinical course of treated HIV disease.
许多接受治疗的HIV感染者即使经过多年治疗，其循环CD8 T细胞数量仍持续居高不下。近期报告表明，CD8 T细胞持续扩增与发生非艾滋病相关疾病事件的较高风险有关。因此，评估CD8 T细胞扩增和持续存在的机制可能有助于深入了解HIV疾病这一具有临床重要性的特征。
急性HIV感染与CD8 T细胞区室的激活和扩增有关。扩增后的CD8 T细胞在整个疾病过程中持续存在，并且与大多数其他病原体免疫反应通常具有的可塑性不同，尽管对HIV复制进行了药物抑制，但许多患者的循环CD8 T细胞数量并未恢复正常。我们怀疑，接受治疗的HIV感染者体内残留的炎症会导致CD8 T细胞进行不依赖抗原的扩增和持续存在，因为这些细胞中的大多数对HIV无反应。
许多接受治疗的HIV感染者的循环CD8 T细胞数量仍异常升高，这种升高与不良临床事件相关。未来需要开展研究来评估CD8 T细胞扩增的机制，并确定CD8淋巴细胞增多症在接受治疗的HIV疾病临床过程中的作用。
