Persistent abnormalities in lymphoid tissues of human immunodeficiency virus-infected patients successfully treated with highly active antiretroviral therapy

Timothy W. Schacker, Phuong L. Nguyen, Esteban Martinez, Cavan Reilly, Jose M. Gatell, Andrzej Horban, Elzbieta Bakowska, Baiba Berzins, Remko Van Leeuwen, Steven Wolinsky, Ashley T. Haase, Robert L. Murphy

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48 Scopus citations

Abstract

Effective highly active antiretroviral therapy (HAART) for human immunodeficiency virus type 1 is associated with virus suppression and immune reconstitution. However, in some patients, this reconstitution is partial or incomplete because CD4+ cell counts do not increase significantly. This may be due to damage in the microenvironment of lymphoid tissues (LTs), where CD4+ T cells reside. To test this hypothesis, LT samples were obtained from 23 patients enrolled in a prospective trial that compared 3 different HAART regimens. Analysis of LT architecture and CD4+ T cells populations revealed abnormalities in 100% of the LT samples, especially in the follicles, with 43% showing absence, 14% showing regression, and 43% showing hyperplasia. CD4+ T cell populations were abnormal in 16 (89%) of 18 tissue samples, with 7 (39%) of 18 decreased by >50% of normal levels. These data are consistent with the hypothesis that persistent abnormalities in the microenvironment can influence immune reconstitution and document persistent LT abnormalities with HAART not detected by measures of peripheral CD4+ T cell count.

Original languageEnglish (US)
Pages (from-to)1092-1097
Number of pages6
JournalJournal of Infectious Diseases
Volume186
Issue number8
DOIs
StatePublished - Oct 15 2002

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Schacker, T. W., Nguyen, P. L., Martinez, E., Reilly, C., Gatell, J. M., Horban, A., Bakowska, E., Berzins, B., Van Leeuwen, R., Wolinsky, S., Haase, A. T., & Murphy, R. L. (2002). Persistent abnormalities in lymphoid tissues of human immunodeficiency virus-infected patients successfully treated with highly active antiretroviral therapy. Journal of Infectious Diseases, 186(8), 1092-1097. https://doi.org/10.1086/343802