Elevated CD38 antigen expression on CD8+ T cells is a stronger marker for the risk of chronic HIV disease progression to AIDS and death in the Multicenter AIDS Cohort Study than CD4+ cell count, soluble immune activation markers, or combinations of HLA-DR and CD38 expression.

Abstract	The prognostic value of several immunologic markers were compared in Los Angeles Multicenter AIDS Cohort Study (MACS) participants, most of whom had been infected with HIV for >8 years. Markers studied included CD4+ cell number, flow cytometric measurements of CD8+ cell expression of CD38 and HLA-DR antigens, and serum markers of immune activation including neopterin, beta2-microglobulin, soluble interleukin-2 receptor, soluble CD8, and soluble tumor necrosis factor receptor-alpha (TNF-alpha) type II. Cox proportional hazards models indicated that elevated CD38 on CD8, a flow cytometric measurement of CD8+ T-lymphocyte activation, was the most predictive marker of those studied for development of a clinical AIDS diagnosis and death. As compared with the reference group, who had CD38 on CD8 <2470 molecules per CD8+ cell and in whom 4 of 99 developed clinical AIDS within 3 years, participants with CD38 on CD8 between 2470 and 3899, 3900 and 7250, and >7250 had relative risks (and numbers developing AIDS within 3 years) of 5.0 (15 of 81), 12.3 (24 of 60), and 41.4 (36 of 49), respectively. The strong prognostic value of CD38 on CD8 measurements and the fundamental importance of chronic immune activation in the pathogenesis of HIV disease suggests that this marker might have utility in the clinical management of HIV-infected persons.
Authors	Z Liu, W G Cumberland, L E Hultin, H E Prince, R Detels, J V Giorgi
Journal	Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association (J Acquir Immune Defic Syndr Hum Retrovirol) Vol. 16 Issue 2 Pg. 83-92 (Oct 01 1997) ISSN: 1077-9450 [Print] United States
PMID	9358102 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, U.S. Gov't, P.H.S.)
Chemical References	Antigens, CD Antigens, Differentiation Biomarkers CD8 Antigens HLA-DR Antigens Interleukin-2 Membrane Glycoproteins Receptors, Tumor Necrosis Factor beta 2-Microglobulin Neopterin ADP-ribosyl Cyclase CD38 protein, human NAD+ Nucleosidase ADP-ribosyl Cyclase 1
Topics	ADP-ribosyl Cyclase ADP-ribosyl Cyclase 1 Acquired Immunodeficiency Syndrome (diagnosis, immunology, mortality) Adult Antigens, CD Antigens, Differentiation (analysis, immunology) Biomarkers CD4 Lymphocyte Count CD8 Antigens (analysis) CD8-Positive T-Lymphocytes (immunology) Chronic Disease Cohort Studies Disease Progression Flow Cytometry HIV Infections (diagnosis, immunology, mortality) HIV Seronegativity HIV Seropositivity HLA-DR Antigens (analysis, immunology) Humans Interleukin-2 (analysis) Male Membrane Glycoproteins NAD+ Nucleosidase (analysis, immunology) Neopterin (analysis) Predictive Value of Tests Prognosis Receptors, Tumor Necrosis Factor Risk Survivors beta 2-Microglobulin (analysis)

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