[HIV infection in stage IV C-2 (CDC). Increase in the p24 antigen value before critical decrease in CD4+ lymphocytes]

Area of Science:

• Immunology
• Virology
• Infectious Diseases

Background:

• The Centers for Disease Control (CDC) classification system for HIV infection includes symptomatic stage IV C-2.
• Stage IV C-2 is characterized by secondary infections such as thrush, oral hairy leukoplakia, and herpes zoster.
• The prognostic value of these symptoms for Acquired Immunodeficiency Syndrome (AIDS) development is established, but the classification lacks immunological parameters.

Purpose of the Study:

• To analyze CD4+ lymphocyte counts and HIV-antigen frequency in HIV-infected individuals.
• To investigate the relationship between stage IV C-2 symptoms and immunological markers.
• To determine if viral protein production in stage IV C-2 is linked to CD4+ T-cell status.

Main Methods:

• Analysis of CD4+ lymphocyte numbers in 65 HIV-infected individuals.
• Assessment of HIV-antigen frequency in the same cohort.
• Comparison of immunological parameters between CDC stages.

Main Results:

• HIV-antigenemia incidence in stage IV C-2 was comparable to full-blown AIDS (53% vs. 60%).
• No significant decrease in CD4+ lymphocytes was observed in stage IV C-2 compared to earlier CDC stages.
• Increased viral protein production was detected in stage IV C-2.

Conclusions:

• In stage IV C-2 of HIV infection, increased viral protein production occurs independently of CD4+ lymphocyte status.
• This suggests a dissociation between viral activity and immune cell decline in this symptomatic stage.
• The findings highlight the complexity of HIV progression beyond simple CD4+ T-cell count metrics.