Natural immunity and HIV disease progression

• Published in: AIDS (London) Vol. 13; no. 5; pp. 557 - 563
• Main Authors: ULLUM, H, LEPRI, A. C, ALADDIN, H, KATZENSTEIN, T, VICTOR, J, PHILLIPS, A. N, GERSTOFT, J, SKINHØJ, P, PEDERSEN, B. K
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.04.1999
• Subjects: AIDS/HIV; Biological and medical sciences; CD16 antigen; CD4 Lymphocyte Count; CD56 antigen; Disease Progression; HIV Infections - immunology; HIV Infections - virology; HIV-1 - immunology; human immunodeficiency virus; Human viral diseases; Humans; Immunity, Innate; Infectious diseases; Killer Cells, Lymphokine-Activated - immunology; Killer Cells, Natural - immunology; Medical sciences; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Human; Immunopathology; Prognosis; Pathogenesis; AIDS; Cellular immunity; Immune deficiency; Infection; Natural killer cell; Immunological investigation; Viral disease; LAK cell; Complication; Evolution; Predictive factor
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/00002030-199904010-00004

To investigate the clinical implications of impaired levels of the natural immunity mediated by natural killer (NK) cells and lymphokine activated killer (LAK) cells during infection with HIV-1. Data used were from 172 individuals with an estimated measure of NK cell activity and 146 with an estimated measure of LAK cell activity. Patients had active HIV infection at the time of enrolment in the study and have been followed-up prospectively for a median of 3.0 years. The lytic activity of NK cells and LAK cells, the CD4 T lymphocyte count, and the concentration of CD16/CD56 NK cells were measured at enrolment. HIV RNA in plasma was measured retrospectively. Survival analysis was performed considering three main endpoints: CD4 cell counts below 100 x 10(6) cells/l, clinical AIDS, and death. In unadjusted analysis and after adjustment for age, CD4 T lymphocyte count and plasma HIV RNA at enrolment, low LAK cell activity was significantly associated with higher risk of progression to a CD4 T lymphocyte count < 100 x 10(6) cells/l (crude P = 0.001; adjusted P = 0.04) and to death (crude P = 0.0002; adjusted P = 0.02). Patients with low NK cell responsiveness to interferon-alpha tended to be at higher risk of death (crude P = 0.04; adjusted P = 0.13) whereas unstimulated NK cell activity and the concentration of NK cells were of no prognostic value for patients in this cohort. The present study suggests that low LAK cell activity and low NK cell responsiveness to interferon-alpha may be important in the pathogenesis of HIV infection.