A hallmark of human immunodeficiency virus type 1 (HIV-1) pathogenesis is the rapid loss of CD4 T cells leading to generalized immune dysfunction, including an exhausted CD8 T cell phenotype. Understanding the necessary factors that govern the functional quality and protective potential of
antiviral T cell responses would facilitate rational
vaccine design and improve therapeutic strategies to combat
persistent infections. Mouse models of chronic
viral infection demonstrate that
interleukin-21 (IL-21), produced primarily by CD4 T cells, is required for the generation and maintenance of functionally competent CD8 T cells and viral containment. We reasoned that preserved
IL-21 production during HIV-1
infection would be associated with enhanced CD8 T cell function, allowing improved viral control. Here we analyzed the ability of CD4 and CD8 T cells to produce several
cytokines in addition to
IL-21 ex vivo following stimulation with overlapping HIV-1
peptides. Both CD4 and CD8 T cells were able to produce
IL-21 in response to HIV-1
infection, with the latter cell type more closely associated with viral control. Furthermore, IL-21-producing HIV-1-specific CD4 T cells (compared to those producing other
cytokines) were the best
indicator of functional CD8 T cells. Our results demonstrate that HIV-1-specific IL-21-producing CD8 T cells are induced following primary
infection and enriched in elite controllers, suggesting a critical role for these cells in the maintenance of
viremia control.