Increased expression of activation markers on CD8 lymphocytes in children with human immunodeficiency virus-1 infection

The aims of the present study were to analyze the impact of perinatal human immunodeficiency virus (HIV)-l infection on lymphocyte maturation in children, to determine the expression of activation markers on CD8 ⁺ cells, and to define predictors of survival in HIV-infected children. Seventy-one children presenting HIV-related symptoms were included in the study; 29 were less than 2 y old and 42 were 2 to 12 y of age. Results were compared with those obtained in normal children of a similar age. In HIV-infected children the proportion of CD4⁺ and CD8 ' CD45RA ⁺ cells was significantly decreased, whereas that of CD8⁺, CD8⁺CD38⁺, and CD8⁺CD45RO⁺ cells was strikingly increased compared with controls. In children less than 2 y old the absolute number of CD4⁺ and CD8⁺CD45RA⁺ cells decreased, and the number of CD8 ⁺ CD45RO⁺ cells increased significantly, whereas the number of CD8⁺ and CD8⁺CD38⁺ cells did not change. The absolute number of CD4⁺ T cells declined with age both among controls and among HIV-infected children. In contrast, the absolute number of CD8⁺ cells and CD8 subsets decreased with age only in controls but not in infected children. In HIV-1-infected children the expression of the CD38 and CD45RO markers on CD8⁺ cells was significantly correlated, indicating that these were activated cells. The survival of less than 2-y-old children with AIDS symptoms was positively correlated with the total number of CD8 cells and CD8⁺CD38⁺ cells at time of entry into the study. Most of the children who died by the end of the study had a CD8 count of less than 750/mm³ and a CD38 ⁺ CD8⁺ count of less than 600/mm3 when first seen, whereas most of those who were alive had higher counts.