CD4+ T cell depletion during all stages of HIV disease occurs predominantly in the gastrointestinal tract

Jason M. Brenchley, Timothy W. Schacker, Laura E. Ruff, David A. Price, Jodie H. Taylor, Gregory J. Beilman, Phuong L. Nguyen, Alexander Khoruts, Matthew Larson, Ashley T. Haase, Daniel C. Douek

Research output: Contribution to journalArticlepeer-review

1334 Scopus citations


The mechanisms underlying CD4+ T cell depletion in human immunodeficiency virus (HIV) infection are not well understood. Comparative studies of lymphoid tissues, where the vast majority of T cells reside, and peripheral blood can potentially illuminate the pathogenesis of HIV-associated disease. Here, we studied the effect of HIV infection on the activation and depletion of defined subsets of CD4+ and CD8+ T cells in the blood, gastrointestinal (GI) tract, and lymph node (LN). We also measured HIV-specific T cell frequencies in LNs and blood, and LN collagen deposition to define architectural changes associated with chronic inflammation. The major findings to emerge are the following: the GI tract has the most substantial CD4+ T cell depletion at all stages of HIV disease; this depletion occurs preferentially within CCR5+ CD4+ T cells; HIV-associated immune activation results in abnormal accumulation of effector-type T cells within LNs; HIV-specific T cells in LNs do not account for all effector T cells; and T cell activation in LNs is associated with abnormal collagen deposition. Taken together, these findings define the nature and extent of CD4+ T cell depletion in lymphoid tissue and point to mechanisms of profound depletion of specific T cell subsets related to elimination of CCR5+ CD4+ T cell targets and disruption of T cell homeostasis that accompanies chronic immune activation.

Original languageEnglish (US)
Pages (from-to)749-759
Number of pages11
JournalJournal of Experimental Medicine
Issue number6
StatePublished - Sep 20 2004


  • CD4 T cell depletion
  • Gastrointestinal tract
  • HIV pathogenesis
  • HIV-specific T cells
  • Lymph nodes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


Dive into the research topics of 'CD4+ T cell depletion during all stages of HIV disease occurs predominantly in the gastrointestinal tract'. Together they form a unique fingerprint.

Cite this