Early Skewed Distribution of Total and HIV-Specific CD8+ T-Cell Memory Phenotypes during Primary HIV Infection Is Related to Reduced Antiviral Activity and Faster Disease Progression

The important role of the CD8(+) T-cells on HIV control is well established. However, correlates of immune protection remain elusive. Although the importance of CD8(+) T-cell specificity and functionality in virus control has been underscored, further unraveling the link between CD8(+) T-cell differentiation and viral control is needed. Here, an immunophenotypic analysis (in terms of memory markers and Programmed cell death 1 (PD-1) expression) of the CD8(+) T-cell subset found in primary HIV infection (PHI) was performed. The aim was to seek for associations with functional properties of the CD8(+) T-cell subsets, viral control and subsequent disease progression. Also, results were compared with samples from Chronics and Elite Controllers. It was found that normal maturation of total and HIV-specific CD8(+) T-cells into memory subsets is skewed in PHI, but not at the dramatic level observed in Chronics. Within the HIV-specific compartment, this alteration was evidenced by an accumulation of effector memory CD8(+) T (T-EM) cells over fully differentiated terminal effector CD8(+) T (T-TE) cells. Furthermore, higher proportions of total and HIV-specific CD8(+) T-EM cells and higher HIV-specific T-EM/(T-EM+T-TE) ratio correlated with markers of faster progression. Analysis of PD-1 expression on total and HIV-specific CD8(+) T-cells from PHI subjects revealed not only an association with disease progression but also with skewed memory CD8(+) T-cell differentiation. Most notably, significant direct correlations were obtained between the functional capacity of CD8(+) T-cells to inhibit viral replication in vitro with higher proportions of fully-differentiated HIV-specific CD8(+) T-TE cells, both at baseline and at 12 months post-infection. Thus, a relationship between preservation of CD8(+) T-cell differentiation pathway and cell functionality was established. This report presents evidence concerning the link among CD8(+) T-cell function, phenotype and virus control, hence supporting the instauration of early interventions to prevent irreversible immune damage.