Decoupling activation and exhaustion of B cells in spontaneous controllers of HIV infection.

Objective: To define the impact of chronic viremia and associated immune activation on B-cell exhaustion in HIV infection.

Design: Progressive HIV infection is marked by B-cell anergy and exhaustion coupled with dramatic hypergammaglobulinemia. Although both upregulation of CD95 and loss of CD21 have been used as markers of infection-associated B-cell dysfunction, little is known regarding the specific profiles of dysfunctional B cells and whether persistent viral replication and its associated immune activation play a central role in driving B-cell dysfunction.