Activated cytotoxic lymphocytes in lymph nodes from human immunodeficiency virus (HIV) 1‐infected patients: a light and electronmicroscopic study

Persistent generalized lymphadenopathy often develops during HIV-infection. It is characterized by follicular hyperplasia which progresses over time to follicular involution and finally lymphocyte depletion. To determine whether activated cytotoxic T cells (CD8+) are present in the hyperplastic germinal centres, light and electronmicroscopic immunogold labelling with monoclonal antibodies were used to localize two cytotoxic molecules, perforin and TIA-1. Perforin and TIA-1-positive cells were detected in the follicles and paracortex of lymph nodes from HIV-infected patients, whereas labelling was seen only in cells of the paracortex in the hyperplastic lymph nodes from HIV-negative patients. Cytotoxic granules, staining positive for perforin and TIA-1, were identified by transmission electronmicroscopy, often in proximity to follicular dendritic cells within the hyperplastic germinal centres of only HIV-positive patients. These cytotoxic cells may play a role in the follicular dendritic cell loss and concomitant follicular involution that occur during the evolution of HIV disease.