CD4 and viral infectious disease: Overall, although decreased CD8+ T cell abundance combined with PD-1 and PD-L1 overexpression may not be sufficient to confer T cell exhaustion, CD4+ and CD8+ depletion with the overexpression of the immune checkpoint molecules may be a marker of exhaustion due to the functions of T helper cells in viral infections, e.g., sustained residual function in exhausted CD8+ T cells.