The CTL response plays a central part in deciding the outcome of viral infections. Evidence from host and viral genetics, gene expression microarrays and assays of T-cell phenotype and function indicate that individual differences in the efficiency of the virus-specific CTL response strongly determine the outcome of infection with the human retroviruses HTLV-1 and HIV-1. It is now believed that differences in anti-viral CTL efficiency or ''quality'' at the single-cell level are critical in determining the efficacy of the host response to viruses. However, it is difficult to identify and quantify the reasons for this apparent individual variation in CTL efficiency, because of the chronic course of infection and the dynamical complexity of the equilibrium that is established between the virus and the host immune response. Specifically, it is unclear whether the observed variations among infected hosts, i.e. in the frequency, phenotype and function or quality of T cells, are the causes or effects -or both -of the variation in the efficiency of virus control.Key words: CTL efficiency . Functional avidity . HIV-1 . HTLV-1 . Polyfunctionality
IntroductionThe CD8 + CTL is an essential component of an effective host immune response to all viral infections [1][2][3][4]. CD8 + T cells suppress viral replication by three main effector mechanisms: production of IFN-g, lysis of virus-infected ''target'' cells via Fas-FasL interaction, or lysis of target cells by the delivery of granzymes and perforin to the infected cell. Of these, the third mechanism is the most rapid and is usually the most important in anti-viral defense.The human retroviruses HIV-1 and HTLV-1 cause lifelong persistent infection in the host. In each case, a proportion of the infected hosts remain asymptomatic. Untreated HIV-1 infection usually causes death from AIDS in about 10 years, but the rate of progression of the disease varies widely among individuals. Moreover, a small proportion of infected hosts -about 0.3% -seem to control HIV-1 replication sufficiently well to remain asymptomatic indefinitely. Such ''HIV controllers'' or ''elite controllers'', usually defined as those who maintain a plasma viral load o50 copies/mL, have recently been intensely investigated in an attempt to identify what constitutes an effective host immune response to the virus [5].HTLV-1 similarly establishes a lifelong persistent infection but, in contrast to HIV-1, over 90% of infected individuals remain indefinitely asymptomatic. Between 1 and 6% develop an aggressive malignancy of CD4 + T cells known as adult T-cell leukemia, which is typically fatal within one year, and a further 0.1-2% develop a disabling chronic inflammatory disease of the central nervous system known as HTLV-1-associated myelopathy/ tropical spastic paraparesis (HAM/TSP). In both HTLV-1 and HIV-1 infection, a dynamic equilibrium is established between persistent viral replication and the host immune response. In each infection, the prevalence and incidence of disease are strongly correlated with the s...