Relationship of CD8(+) T cell noncytotoxic anti-HIV response to CD4(+) T cell number in untreated asymptomatic HIV-infected individuals.

During chronic HIV infection, asymptomatic individuals demonstrate a strong CD8(+) cell noncytotoxic antiviral response (CNAR). With the onset of symptoms or reduction in CD4(+) cell counts, CNAR decreases. Presently, it is recommended that infected individuals receive antiretroviral therapy if CD4(+) cell counts fall below 350 cells/microL. To determine whether CNAR lends support to this recommendation for initiation of antiretroviral treatment, we examined CNAR in 20 healthy, untreated, HIV-infected men exhibiting a range of CD4(+) cell numbers. Our results indicate that the asymptomatic untreated HIV-infected individuals with less than 300 CD4(+) cells/microL had a significantly lower CNAR than those with higher CD4(+) cell counts. These data on CNAR in untreated, healthy, HIV-infected individuals support the current recommendation for when to initiate antiretroviral therapy.