Acute Cytomegalovirus Infection Is Associated with Increased Frequencies of Activated and Apoptosis-Vulnerable T Cells in HIV-1-Infected Infants

ABSTRACT Cytomegalovirus (CMV) coinfection is associated with infant HIV-1 disease progression and mortality. In a cohort of Kenyan HIV-infected infants, the frequencies of activated (CD38 + HLA-DR + ) and apoptosis-vulnerable (CD95 + Bcl-2 − ) CD4 + and CD8 + T cells increased substantially during acute CMV infection. The frequency of activated CD4 + T cells was strongly associated with both concurrent CMV coinfection ( P = 0.001) and HIV-1 viral load ( P = 0.05). The frequency of apoptosis-vulnerable cells was also associated with CMV coinfection in the CD4 ( P = 0.02) and CD8 ( P < 0.001) T cell subsets. Similar observations were made in HIV-exposed uninfected infants. CMV-induced increases in T cell activation and apoptosis may contribute to the rapid disease progression in coinfected infants.