Activation and maturation of peripheral blood T cells in HIV-1-infected and HIV-1-uninfected adults in Burkina Faso: a cross-sectional study

Background: We wanted to explore to what extent environmental exposure to immune stimulants, which is expected to be more present in rural than in urban settings, influences T cell activation and maturation in healthy and in HIV-1-infected individuals in Burkina Faso in west Africa. Methods: The proportion of circulating naive T cells and the expression of the T cell activation markers, CD95 and CD38, were analyzed by immunophenotyping and three-colour flow cytometry in 63 healthy individuals and 137 treatment-naive HIV-1-infected subjects from Ouagadougou (urban setting) and 26 healthy adults and 61 treatment-naive patients from Nouna (rural). Results: A slightly higher activation level of CD4(+) and CD8(+) peripheral blood T cells was seen in healthy adults living in Nouna than in those living in Ouagadougou. The percentages of naive CD45RA(bright) CCR7(+) T cells were not significantly different between both study sites. Taking into consideration that relatively more HIV-1-infected patients in Nouna were in an advanced disease stage, no relevant differences were seen in T cell activation and maturation between patients at both study sites. As expected, the percentage of CD95(+) CD4(+) and CD38(+) CD8(+) T cells and the respective antigen density on these cells was significantly higher in patients than in controls in both settings. The percentage of naive CD8(+) T cells was lower in HIV-1-infected subjects than in healthy controls irrespective of the study site, while a lower proportion of naive CD4(+) T cells in patients compared with controls was seen only in Nouna. Conclusions: Environmentally triggered immune activation may contribute to the increased expression of the activation markers CD95 and CD38 on peripheral blood T cells from healthy adults living in rural versus urban settings in Burkina Faso. T cell activation is further increased in HIV-1-infected individuals due to T cell loss and high plasma viral load levels. The observed variations in T cell activation levels or the proportion of naive T cells in our study patients, however, are not explained by differences in CD4(+) T cell counts or HIV-1 plasma viral load levels alone.