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Blood, 15 July 2004, Vol. 104, No. 2, pp. 470-477.
Prepublished online as a Blood First Edition Paper on April 1, 2004; DOI 10.1182/blood-2003-12-4265.


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IMMUNOBIOLOGY

De novo T-cell generation in patients at different ages and stages of HIV-1 disease

Massimo Nobile, Rafael Correa, José A. M. Borghans, Claudia D'Agostino, Philippe Schneider, Rob J. de Boer, and Giuseppe Pantaleo, for the Swiss HIV Cohort Study

From the Laboratory of AIDS Immunopathogenesis, Division of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Laboratory of Molecular Immuno-Biology, Hospital General Universitario Gregorio Marañón (HGUGM), Madrid, Spain; Department of Clinical Viro-Immunology, Sanquin Research at Centraal Laboratorium van de Bloedtransfusiedienst van het Nederlandse Rode Kruis (CLB) and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, The Netherlands; Service Régional Vaudois de Transfusion Sanguine, Lausanne, Switzerland; and Theoretical Biology, Utrecht University, The Netherlands.

We assessed de novo T-cell generation by determining T-cell receptor-rearrangement excision circles (TRECs) based on patient age and on stage of HIV-1 infection. TRECs were measured in purified CD4 and CD8 T cells of a large cohort of HIV-1-infected subjects (n = 297) with chronic infection but no previous antiretroviral treatment and of a control group of HIV-negative subjects (n = 120). HIV-1-infected subjects were stratified on the basis of CD4 T-cell counts in 3 groups, early-stage disease (more than 500 CD4 T cells), intermediate-stage disease (200-500 CD4 T cells), and late-stage disease (fewer than 200 CD4 T cells). Compared with the control group, CD8 TREC contents were severely reduced (P < .001) in HIV-1-infected subjects regardless of the stage of HIV disease. In contrast, CD4 TREC contents were significantly increased (P = .003) in HIV-1-infected subjects during early-stage disease, similar at intermediate-stage disease, and severely reduced only at late-stage disease. We show that the increase in CD4 TRECs was mostly limited to younger (younger than 45 years) patients at early-stage disease. Our results demonstrate a dichotomy between TREC contents in CD4 and CD8 T-cell populations in HIV-1 infection and indicate that thymus function in younger subjects is preserved at early and intermediate stages of HIV infection. (Blood. 2004;104:470-477)


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