Recent evidence suggests that T cell apoptosis could be involved in the pathogenesis of HIV-1 infection. As the progression of HIV-2 associated disease appears to be slower than that of HIV-1, we investigated whether there were differences in the degree of T cell death and apoptosis in peripheral blood mononuclear cell (PBMC) cultures from patients with HIV-1 or HIV-2 infection. PBMC from healthy controls (n = 28) and patients infected with HIV-1 (n = 26: asymptomatic (ASY)/persistent generalized lymphadenopathy (PGL), n = 16; and AIDS-related complex (ARC)/AIDS n = 10) or HIV-2 (n = 30: ASY/PGL, n = 16; ARC/AIDS, n = 14) were cultured in the absence or presence of mitogens (PHA, PWM) or superantigen (SEB). After 48 h, cell death (CD) was assessed by trypan blue exclusion and in some patients programmed cell death (PCD) was quantified in flow cytometry by measuring the percentage of hypodiploid nuclei corresponding to fragmented DNA, after treating the cells with a propidium iodide hypotonic solution. HIV-1 and HIV-2 ARC/AIDS patients and ASY/PGL HIV-1+ patients had significant increases in cell death percentages compared with controls, both in unstimulated and stimulated lymphocyte cultures. However, HIV-2+ ASY/PGL patients did not exhibit significant increases of cell death in unstimulated cultures. In addition, the comparison between HIV-1 and HIV-2 infected subjects in similar stages of disease, showed no significant differences in CD in the ARC/AIDS patients, although ASY/PGL HIV-2 infected subjects had lower levels of CD than the HIV-1+ ASY/PGL (3.4% +/- 0.6 s.e.m. versus 6.8% +/- 1.1 s.e.m., P < 0.01). PCD was significantly increased both in ASY/PGL (14.3% +/- 2.2 s.e.m., n = 8, P < 0.005) and in ARC/AIDS (25.3% +/- 4.5 s.e.m., n = 9, P < 0.001) HIV-1+ patients compared with healthy controls (5.8% +/- 1.7 s.e.m., n = 11). This contrasts with HIV-2 infected subjects where the ASY/PGL patients (10.0% +/- 2.8 s.e.m., n = 6) did not differ significantly from healthy controls, although ARC/AIDS patients (27.2% +/- 4.2 s.e.m., n = 9, P < 0.001) had significantly increased levels of PCD. In conclusion, this is the first report describing the occurrence of spontaneous and activation-induced lymphocyte death by apoptosis in HIV-1 infected subjects.(ABSTRACT TRUNCATED AT 400 WORDS)