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[The correlation of HIV-1 viral load to expression of CD8+ T lymphocyte activators CD38 and HLA-DR].

OBJECTIVE
To investigate the correlation of CD38 and HLA-DR abnormal activating expression on CD8+ T with plasma viral load (VL) and evaluate the possibility of the economical CD38 and HLA-DR test to substitute VL assay in HIV/AIDS patients.


METHODS
A multi-point correlation study of the percentage of CD38 and HLA-DR on CD8+ T by flow cytometry with plasma VL by bDNA was performed in 103 HIV/AIDS patients during a 12-month highly active anti-retroviral therapy (HAART). The cutoff values of CD38 and HLA-DR were evaluated with ROC area, sensitivity and specificity for predictive VL < 50 copies/ml, < 500 copies/ml, > 1000 copies/ml and > 10,000 copies/ml respectively.


RESULTS
The level of CD38 and HLA-DR on CD8+ T in 103 patients decreased gradually with the reduction of VL during a 12-month HAART. The correlation of CD38 and HLA-DR with VL in the year of HAART was 0.424, 0.376, 0.335, 0.326, 0.297, 0.285 and 0.377, 0.318, 0.333, 0.312, 0.361, 0.358 with significant P value. Moreover, the overall correlation of CD38 and HLA-DR with VL were 0.483 (P < 0.001) and 0.477 (P < 0.001). Depending on optimal ROC, sensitivity and specificity for the substitute method, the cutoffs percentage of CD38 were < 68.5% and < 72.5% for predictive VL < 50 copies/ml and < 500 copies/ml as well as > 39.5% and > 46.5% of HLA-DR cutoff to predict VL > 1000 copies/ml and > 10,000 copies/ml.


CONCLUSION
The detection of CD38 and HLA-DR percentage expression on CD8+ T can be available for prediction about HIV VL assay as a substitute method to survey the disease progression and HAART outcome in some resource-limited areas of China.