Summary
Peripheral blood mononuclear cells (PBMC) of untreated, HIV‐infected patients contain HIV‐specific CD8 T cells as well as their corresponding targets, HIV‐infected CD4 T cells. To determine if CD4 T‐cell depletion in HIV‐infected patients may result from autologous CD8–CD4 T‐cell interaction, CD8 and CD4 T cells procured from PBMC of acute and chronic untreated HIV‐infected patients were sorted and co‐incubated. Formation of CD8‐CD4 T‐cell conjugates was observed by fluorescence microscopy. Apoptosis of CD4 T cells in conjugation was recorded by digitized images and was further observed and measured by FACS using Annexin staining. Perforin expression in the CD8 T cells was measured using intracellular monoclonal perforin antibody staining. HIV DNA in the conjugated CD4 T cells was detected by in situ PCR. We found that 6·1 ± 0·5% of CD4 T cells from acute HIV‐infected patients and 3·0 ± 0·5% from chronic HIV‐infected patients formed CD8–CD4 T‐cell conjugates. Annexin binding and cell morphology typical of apoptosis were observed in the conjugated CD4 T cells. The majority of CD8 T cells that had conjugated to CD4 T cells expressed perforin. The conjugated CD4 T cells exhibited nuclear HIV DNA. CD8 T cells and HIV‐infected CD4 T cells, both procured from the PBMC of untreated HIV‐infected patients, form conjugates. Apoptotic lytic activity has been observed in the conjugated CD4 T cells. We propose that CD4 T‐cell annihilation in HIV‐infected patients results, at least in part, from the interactions of perforin‐rich CD8 T cells with autologous, HIV‐infected CD4 T cells.