OBJECTIVETo study the expression of CD38 and HLA-DR on CD8(+) T cells in pediatric AIDS patients receiving highly active antiretroviral therapy (HAART) and the relationship of immune activation and disease progression.

METHODSA cross-section study of 194 pediatric AIDS patients receiving HAART was carried out and 52 age-matched healthy children were recruited as control. The percentage of CD4(+), CD8(+), CD8(+)/CD38(+) and CD8(+)/HLA-DR(+) T cells was tested using flow cytometry, and HIV-RNA in plasma was detected by quantitative RT-PCR.

RESULTSOne hundred and ninety-four pediatric AIDS patients were divided into two groups according to the viral load: 59 patients with VL ≥ 400 copies/ml and 135 patients with VL < 400 copies/ml. The percentage of CD8(+)/CD38(+) and CD8(+)/HLA-DR(+) T cells of patients with VL ≥ 400 copies/ml was significantly higher than that of patients with VL < 400 copies/ml (P < 0.05). Of patients with VL < 400 copies/ml, the percentage of CD8(+)/CD38(+) T cells was nearly normal, and the percentage of CD8(+)/HLA-DR(+) T cells was higher than normal level (P < 0.05). There was a positive correlation between percentage of CD8(+)/CD38(+) and of CD8(+)/HLA-DR(+)T cells and viral load (R = 0.403, P = 0.03 for the former and R = 0.569, P = 0.09 for the later).

CONCLUSIONSEffective HAART could decrease immune activation of HIV-infected children significantly. And there was a positive correlation between percentage of CD8(+)/CD38(+) and of CD8(+)/HLA-DR(+)T cells and viral load, suggesting that the two indicators might be used as the substitution of viral load in resource-limited areas.