Relative preservation of natural killer cell cytotoxicity and number in healthy AIDS patients with low CD4 cell counts

Gail Ironson, Elizabeth Balbin, George Solomon, John Fahey, Nancy Klimas, Neil Schneiderman, Mary Ann Fletcher

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Objective: This study examines whether there may be an immune component that protects a relatively rare group of HIV-infected people with very low CD4 cell counts (≤ 50 × 106/l) who have prolonged asymptomatic periods. Design/methods: Three groups were recruited in Miami: (i) healthy low CD4 cell count patients (HLC; n = 30) who, for 9 months had < 50 × 106 CD4 cells/l, were asymptomatic and were not on protease inhibitors during that time; (ii) HIV comparison group (Comp; n = 60) who had CD4 cell counts predominantly 150 × 106 to 400 × 106/l and never had AIDS Category C symptoms; this group was also followed for CD4 cell count and viral load change over 6 months; and (iii) healthy community controls (n = 33). The study was replicated at the University of California at Los Angeles (UCLA) with HLC (n = 31) versus HIV-negative laboratory controls (n = 28). Results: The HLC patients were significantly higher than the Comp group on natural killer cell cytotoxicity (NKCC) and natural killer cell number (NK#) despite their lower CD4 cell numbers and higher viral loads. In fact, there was no difference between the HLC group and the healthy community control group in NK# or NKCC. The NK findings were replicated at UCLA. A retrospective analysis showing that higher NKCC was related to fewer prior symptoms in the HLC group, and prospective analysis in the Comp group showing that NK# predicted a lower increase in viral load over 6 months further supported the importance of NK# and NKCC. Conclusions: Non-specific cellular immunity may be a factor protecting the health of HIV sero-positive individuals with very low CD4 cell counts.

Original languageEnglish (US)
Pages (from-to)2065-2073
Number of pages9
Issue number16
StatePublished - Nov 9 2001


  • AIDS
  • Disease progression
  • HIV
  • NK cytotoxicity
  • NK number
  • Survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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