INTRODUCTION
Multiple studies have examined apoptosis in CD4 T cells infected with human immunodeficiency virus (HIV) in vitro or in CD4 T lymphocytes isolated from HIV-seropositive patients and cultured ex vivo.1 Although these studies documented multiple mechanisms by which HIV can engage signal transduction pathways that initiate apoptosis, evidence that these contribute to CD4 T lymphocyte depletion in vivo is more limited.
In this regard, a central issue is whether the induction of apoptosis observed represents an essential cause of the selective CD4 T lymphocyte depletion that characterizes HIV infection or whether apoptosis represents an epiphenomenon in association with chronic viral infection and immune activation, as was observed in other viral infections.2 Attempts to correlate levels of apoptosis with rates of HIV disease progression have produced mixed results—some demonstrate an association,3,4 and others fail to do so.5
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