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Summary. A cohort of 98 HIV-infected initially AIDS-free homosexual men from the Multicenter AIDS Cohort Study (MACS) was followed for 6 years to investigate whether CD8 cell subsets have prognostic value for progression to AIDS. In the present study, four subsets of CD8 T cells that previously have been shown to be selectively elevated in HIV-infected asymptomatic persons, specifically the CD8 T cell subsets that were CD38 , HLA-DR , CD57 and L-selectin negative (Leu8-), were measured. Forty-nine of the 98 developed AIDS. Prognostic value of these CD8 cell subsets was evaluated using the proportional hazards model. Levels of both CD38 CD8 and Leu8-CD8 cells individually had prognostic value for progression to AIDS. In contrast, CD57 CD8 and HLA-DR CD8 cell subset levels did not have prognostic value. After adjustment for level of CD4 T cells, however, only the elevation in the CD38 CD8 cell subset had additional prognostic value. These results suggest that the level of CD38 CD8 cells could be used together with the CD4 T cell level to more accurately predict progression to AIDS among HIV-infected men. These results provide further support for the observation that dramatic and progressive activation of CD8 T cells in HIV infection occurs. The power of elevated levels of the CD38 CD8 subset to predict poor prognosis in this cohort suggests these CD8 T cells reflect an immune stimulation that is ultimately unable to control disease progression.

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