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* Department of Cancer Immunology & AIDS, Dana-Farber Cancer Institute, Boston MA 02115;
Infectious Disease Unit, Massachusetts General Hospital, Boston, MA 02114;
Infectious Diseases and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03755;
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA 02215; and
¶ Department of Pathology,
|| Department of Medicine, and
# Department of Neurology and
** Program in Immunology, Harvard Medical School, Boston, MA 02115
Chronic infection with the HIV results in poor HIV-specific CD4 T cell proliferation, but more recent analyses using intracellular cytokine staining demonstrated that IFN-
-producing, HIV-specific CD4 T cells can be detected for years in HIV-infected subjects. Because it is not known whether the majority of HIV-specific T cells are lost or become dysfunctional, we examined the kinetics of the T cell response over an extended period of time using a panel of 10 HLA-DR tetramers loaded with HIV p24 peptides. Tetramer+ CD4 T cells were present at a relatively high frequency during acute infection, but the size of these populations substantially contracted following suppression of viral replication. Short-term cessation of antiretroviral therapy resulted in a burst of viral replication and concomitant expansion of tetramer+ CD4 T cells, and these populations again contracted following reinitiation of therapy. The kinetics with which these cell populations contracted were characteristic of effector T cells, a conclusion that was supported by their phenotypic (CCR7–CD45RA–) and functional properties (IFN-+). Continued high-level viremia resulted in the physical loss of the majority of tetramer+ CD4 T cells, and the decline of HIV p24-specific CD4 T cells occurred more rapidly and was more substantial than the reduction of total CD4 T cell numbers. We conclude that the population of HIV p24-specific CD4 T cells is initially responsive to changes in the levels of viral Ags, but that the majority of these cells are lost in a setting of chronic viremia.
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