Changes in lymphocyte subsets in human immunodeficiency virus-positive persons with < 5 CD4 T lymphocytes/mm3

All patients seen at the Royal Free Hospital, London, who had at least one CD4 T lymphocyte count of < 5 cells/mm3 (n = 166) were prospectively followed to assess changes in their total T lymphocyte and CD8 T lymphocyte counts over time. While overall there were no clear trends towards a drop or increase in either count, persons who died during the study experienced a rapid drop in both CD8 T lymphocyte and total T lymphocyte levels in the months preceding death. Multivariate Cox proportional hazards models revealed that both the total T lymphocyte count and CD8 T lymphocyte count provided important prognostic information for survival. Despite almost a complete absence of CD4 T lymphocytes, lymphocyte subset monitoring is useful in identifying decreasing CD8 T lymphocyte levels that predict short-term prognosis.