A longitudinal study of a patient with acquired immunodeficiency syndrome using T cell subset analysis

Acquired Immunodeficiency Syndrome (AIDS) has recently been documented in patients in association with opportunistic infections, Kaposi's sarcoma, cytomegalovirus infections, and recreational drug use. AIDS is characterized by cutaneous energy, diminished peripheral lymphocyte responses to mitogens and antigens, and abnormal T cell subpopulations. These patients have been described as having decreased total T (T3+) cell numbers, virtual elimination of the T helper (T4+) cell population, and an increased percentage of the T suppressor-cytotoxic (T8+) cell population. T cell subset monitoring has not been performed during the course of this disorder. A four month longitudinal study of the T cell subsets of a 30 year old bisexual male with AIDS revealed changes in his T cell subpopulations and in his ability to respond in a one way mixed lymphocyte culture (MLC). The results indicated that the patient's previously abnormal T cell subpopulations returned to near normal values during a period of spontaneous clinical improvement. The patient's MLC response also returned to normal in association with the return of the T helper cell population. The patient's T cell subpopulation and MLC response subsequently became abnormal and remained abnormal until the patient died. Thus, it appears that T cell subpopulations may spontaneously improve during the course of this disorder. T cell subset analysis may offer a means of monitoring the clinical course of this disorder as well as the response to therapeutic agents.