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Distinct mechanisms of T cell reconstitution can be identified by estimating thymic volume in adult HIV-1 disease.

Authors :
Kalayjian RC
Spritzler J
Pu M
Landay A
Pollard RB
Stocker V
Harthi L
Gross BH
Francis IR
Fiscus SA
Tebas P
Bosch RJ
Valcour V
Lederman MM
Adult AIDS Clinical Trials Group. 5015 and 5113 Study Teams
Source :
Journal of Infectious Diseases. 11/1/2005, Vol. 192 Issue 9, p1577-1587. 11p.
Publication Year :
2005

Abstract

BACKGROUND: We have attempted to identify factors associated with T cell reconstitution in response to highly active antiretroviral therapy. METHODS: In a prospective, multicenter cohort study, we compared clinical, immune, and viral responses to an initial antiretroviral regimen in older (>or=45 years old) versus younger (18-30 years old) human immunodeficiency virus type 1-infected subjects. Multivariable linear-regression models identified independent factors associated with changes in T cell counts. RESULTS: Older subjects had smaller increases in naive T cells but greater T cell receptor-excision circle DNA content after 48 weeks, despite similar virologic responses and comparable reductions in immune activation. Changes in T cell counts were associated with plasma interleukin (IL)-7 levels in subjects with low thymic scores, whereas first-phase T cell increases (perhaps mediated by redistribution to the circulation of tissue-associated lymphocytes) were associated with reductions in immune activation in subjects with high thymic scores. Reductions in immune activation were associated with reductions in spontaneous lymphocyte apoptosis. CONCLUSIONS: Distinct processes may underlie T cell restoration, according to estimated thymic volumes. IL-7-mediated peripheral expansion may drive T cell restoration in persons with low thymic volume, whereas therapy-associated reversal of immune reactivation may drive T cell losses and their restoration in persons with larger thymic volume. Copyright © 2005 Infectious Diseases Society of America [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00221899
Volume :
192
Issue :
9
Database :
Academic Search Index
Journal :
Journal of Infectious Diseases
Publication Type :
Academic Journal
Accession number :
106343798
Full Text :
https://doi.org/10.1086/466527