Article: article from journal or magazin.
Discordant increases in CD4+ T cells in human immunodeficiency virus-infected patients experiencing virologic treatment failure: role of changes in thymic output and T cell death.
Journal of Infectious Diseases
Some patients infected with human immunodeficiency virus (HIV) who are experiencing antiretroviral treatment failure have persistent improvement in CD4+ T cell counts despite high plasma viremia. To explore the mechanisms responsible for this phenomenon, 2 parameters influencing the dynamics of CD4+ T cells were evaluated: death of mature CD4+ T cells and replenishment of the CD4+ T cell pool by the thymus. The improvement in CD4+ T cells observed in patients with treatment failure was not correlated with spontaneous, Fas ligand-induced, or activation-induced T cell death. In contrast, a significant correlation between the improvement in CD4+ T cell counts and thymic output, as assessed by measurement of T cell receptor excision circles, was observed. These observations suggest that increased thymic output contributes to the dissociation between CD4+ T cell counts and viremia in patients failing antiretroviral therapy and support a model in which drug-resistant HIV strains may have reduced replication rates and pathogenicity in the thymus.
Adult, Anti-HIV Agents/therapeutic use, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes/immunology, Cell Death, Cells, Cultured, Cohort Studies, Fas Ligand Protein, Female, HIV Infections/drug therapy, HIV Infections/immunology, HIV-1, Humans, Leukocytes, Mononuclear/immunology, Male, Membrane Glycoproteins, Middle Aged, Receptors, Antigen, T-Cell/analysis, Thymus Gland/immunology, Treatment Failure, Viral Load, Viremia
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