CD4+ CD38+ HLA-DR+ level as biomarker for evolution of HIV infection regardless of antiviral therapy

Introduction. HIV infection is characterized by an enhanced synthesis of cytokines and chemokines, a quantitative T cells disequilibrium and increased Turn over that signs a chronic activation of the immune system. Phenotype change in CD4+ T cells by overexpression of activation antigens CD38 and HLA-DR are suggested as markers of this process. Materials and methods. We investigated by four-color flow cytometry the expression of both activation markers on peripheral CD4+ T cells in 106 HIV-1 Algerian infected patients and 34 uninfected controls. Percentages expression of CD4+CD38+HLA-DR+ cells was compared with clinical stages, viral load and anti-retroviral treatment (ARV). Results. The proportion of CD4+ T cells coexpressing HLA-DR and CD38 was higher in infected patients than in controls (respectively, 14.2 % ± 3.6 vs. 5.8 % ± 4.1 , P=0.01), in symptomatic HIV patients than asymptomatic (13 % ± 3 vs. 15.9 % ± 4.6, P=0.01) and followed viral load kinetics. In matched treated and untreated patients, activated CD4+T proportion does not show any statical difference (respectively, 13 % and 14 %, p=0.09). Conclusion. In our cohort, CD4+ T cells expressing CD38 and HLA-DR were associated with HIV infection and correlated with disease progression, regardless of ARV treatment. As CD4+ count and viral load, this lymphocyte subset may be an interesting disease evolution marker; its value remains to be determined in prognostic or as therapy response indicator.