Conservation of total T-cell counts during HIV infection: alternative hypotheses and implications

J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Apr 15;17(5):450-7. doi: 10.1097/00042560-199804150-00010.

Abstract

While CD4+ T-cell counts in the blood of HIV-infected individuals gradually decrease, there is a parallel increase in the number of blood CD8+ T cells such that the total number of T cells remains essentially constant for several years (1). The basis and significance of this phenomenon are not known. Based on a statistical analysis of longitudinal T-cell counts from the Transfusion Safety Study (TSS) database and on theoretical considerations, we evaluate several alternative models, including versions of the "blind homeostasis" (BH) hypothesis (1-3). At issue is the nature of the homeostatic regulation of lymphocytes and its apparent failure in HIV infection. The most plausible explanation for the conservation of total blood T-cell numbers while subset ratios change is that CD4+ and CD8+ T cells compete for a limited access to the blood compartment. Such interaction between the subsets implies, in particular, that changes in the number of CD4+ T cells occurring in other tissues cannot be reliably inferred from those observed in the blood. We reiterate propositions made earlier (4) that much of the apparent "depletion" of CD4+ lymphocytes during the asymptomatic phase of HIV infection may be attributed to redistribution between the tissues and the blood compartment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • CD4 Lymphocyte Count
  • CD4-CD8 Ratio
  • HIV Infections / blood*
  • HIV Infections / immunology
  • HIV Infections / virology
  • Homeostasis
  • Humans
  • Lymphocyte Count
  • Models, Biological
  • T-Lymphocytes / cytology
  • T-Lymphocytes / immunology*