Control of human cytomegalovirus infection in patients infected with human immunodeficiency virus by high levels of specific CD8+ T-cells

ABSTRACTA new technique was used to simultaneously determine human cytomegalovirus (HCMV)-specific CD4+ and CD8+ T-cells in highly active anti-retroviral therapy (HAART)-naive and HAART-treated patients infected with human immunodeficiency virus (HIV). HIV-infected patients with HCMV infection, but without HCMV disease, showed low numbers of HCMV-specific CD4+ cells and high numbers of CD8+ T-cells, both before and during HAART. HIV-infected patients with HCMV disease had no HCMV-specific CD4+ T-cells and extremely low levels of CD8+ T-cells. Resolution of disease during HAART was associated with rescue of specific CD4+ T-cells and a large increase in the specific CD8+ T-cell count. Thus, HAART does not completely restore the normal immune function. In HIV-infected patients, sustained control of HCMV infection requires high frequencies of specific CD8+ T-cells.