Abstract
Objective: Opportunistic infections which occur in HIV-infected patients are also seen in hematological disorders such as multiple myeloma and malignant lymphoma. To assess the difference in perturbation in T-cell subsets, we evaluated CD4 subsets in both diseases. In addition, changes in increased CD4 T-cell subsets by anti-retroviral therapy in HIV-infected patients were analyzed.
Method: PBMCs of 17 HIV-infected patients, 10 multiple myeloma (MM) patients and 9 malignant lymphoma (ML) patients were FACS scanned by two-color immunofluorescence analysis with monoclonal antibodies against CD4, CD8, CD45 RA, CD45 RO, CD 25 and HLA-DR.
Results: In HIV-infected patients, memory cells (CD4+ CD45 RO+) and naive cells (CD4+ CD45 RA+) were well preserved except in the patients with extremely low CD4 cells. On the contrary, in MM and ML patients, memory CD4 cells were well preserved while naive CD4 cells were obviously depleted even in patients with high CD4 cell counts. CD8 cell numbers were correlated with CD4 cell numbers more strongly in MM and ML patients than in HIV-infected patients. Other CD4 subset patterns were not different in among patients. After anti-retroviral therapy, a rise in CD4 cells observed in 8 HIVinfected patients was found to reflect a rise in memory CD4 cells. The increase in naive CD4 cells was very slow, or was not found in some cases.
Conclusion: Decreased naive CD4 cells and reciprocally high memory CD4 cells in MM and ML patients were observed. In HIV-infected patients, both memory and naive CD4 cells were equally impaired but early restoration of memory CD4 cells might be expected by anti-retroviral therapy. An increase in naive CD4 cells seemed to play an important role in the remission of opportunistic infections.
