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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

Krishna V. Komanduri, Judith Feinberg, Robert K. Hutchins, Ronald D. Frame, Diane K. Schmidt, Mohan N. Viswanathan, Jacob P. Lalezari and Joseph M. McCune
The Journal of Infectious Diseases
Vol. 183, No. 8 (Apr. 15, 2001), pp. 1285-1289
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30061824
Page Count: 5
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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 CMVspecific 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 (0.60/%-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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