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T cell apoptosis represents a common mechanism of T cell depletion in HIV-1-infected individuals reflecting maturational and functional T cell abnormalities either directly or indirectly induced by the virus. In the present study, the effects of highly active antiretroviral therapy (HAART) on the spontaneous apoptosis of distinct T cell subsets were investigated during a 6-month follow-up in a cohort of HIV-1-infected individuals with CD4(+) cell counts between 100 and 500 cells/microliter and plasma HIV-1 RNA levels >/=10, 000 copies/ml. We determined that the rapid and sustained increase of both naive (CD45RA(+)CD62L(+)) and memory (CD45R0(+) and CD45RA(+)/CD62L(-)) CD4(+) and, to as lesser extent, CD8(+) T cells in peripheral blood was associated with a significant decrease of apoptotic CD4(+) and CD8(+) as well as CD3(+)CD4(-)CD8(-) T cells. Among CD4(+) lymphocytes, at enrollment, the highest frequency of apoptotic cells was observed within the memory compartment, as defined by CD45R0 expression. During HAART, however, the frequency of CD4(+)CD45R0(+) apoptotic T cells progressively decreased in association with a significant downregulation of surface activation markers that indicated decreased levels of systemic immune stimulation. These results indicate that effective viral suppression can contribute to progressive normalization of maturational and functional T cell abnormalities responsible for the high levels of T cell apoptosis in HIV-1-infected individuals. This, in turn, may contribute to a reduced rate of T cell loss and immune reconstitution during HAART., (Copyright 2000 Academic Press.)

Central nervous system (CNS) disorders are frequent in HIV-1-infected individuals, particularly in newborns and children, and are accompanied by histological alterations resulting in neuronal loss. Although several tumor-derived neuroectodermal cell lines can be infected by HIV-1, it has been reported that primary neural cells cannot be infected after they differentiate. However, pediatric AIDS is often the result of HIV-1 infection occurring during fetal development and early postnatal life, when neural cells are not yet differentiated. Here we show that primary cell cultures derived from the human fetal olfactory system which are representative of the developing CNS can be infected by both HIV-1 strains, the monocyte-macrophagotropic BaL and the lymphotropic HTLV-IIIB, although they do not express the CD4 molecule. In addition, the levels of viral replication are higher with the HIV-1 BaL than with the IIIB isolate. These results suggest that (1) during development immature neurons are susceptible to HIV-1 infection; (2) monocyte-macrophagotropic HIV-1 strains may preferentially be involved in the productive infection of the nervous system; and (3) a mechanism(s) other than the CD4-mediated viral entry is responsible for HIV-1 infection of immature neurons.

Human immunodeficiency virus type 1 (HIV-1) can be isolated from lymphocytes and tissues of symptomatic and asymptomatic seropositive subjects. However, in some individuals, virus isolation is not always positive, especially in asymptomatics. In this paper we report the results of HIV-1 DNA detection by means of polymerase chain reaction (PCR), a new technique that permits the amplification of specific DNA sequences. PCR was carried out to amplify two highly conserved env regions on samples from 20 normal individuals used as controls, 20 seropositive patients at different stages of HIV disease and 25 seronegative individuals at high risk for infection, such as sexual partners of seropositive patients and intravenous drug addicts. Eighteen out of 20 seropositive subjects were positive by PCR while among seronegatives HIV DNA was detected in 7/25 individuals. Virus isolation was positive only in 2/7. These subjects, followed for HIV antibody production for a period of 10-12 months, remained seronegative except one case who seroconverted after a few weeks. Long latency of HIV infection without detectable antibodies seems prevalent in these subjects. PCR assay represents a useful technique for identifying proviral sequences in seronegative high-risk individuals, to confirm the infection during its early phases and during the follow-up of patients with HIV disease.