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Blood, 15 May 2002, Vol. 99, No. 10, pp. 3702-3706
IMMUNOBIOLOGY
T-cell repopulation and thymic volume in HIV-1-infected adult
patients after highly active antiretroviral therapy
Jaime M. Franco,
Amalia Rubio,
Manuel Martínez-Moya,
Manuel Leal,
Elena Merchante,
Armando Sánchez-Quijano, and
Eduardo Lissen
From the Department of Internal Medicine (the Viral
Hepatitis and AIDS Study Group) and Department of Radiology, Hospital
Universitario Virgen del Rocío, Seville, Spain.
The origin of T cells after highly active antiretroviral therapy
(HAART) in patients infected with human immunodeficiency virus 1 (HIV-1) is now under discussion. The possibility of renewed lymphopoiesis in aged thymuses is still controversial. In this work we
combine the analysis of naïve T cells, T-cell receptor excision
circles (TRECs), and computed tomography scanning of thymic tissue to
further assess whether the thymus is involved in immune reconstitution.
Fifteen antiretroviral-naïve HIV-1-infected patients were
evaluated during 48 weeks of HAART. At baseline, significant
correlation was present among age and both thymic volume and TRECs, and
between naïve T cells and TRECs. After starting HAART, there
was a significant increase at week 12 in naïve CD4+
and CD8+ T cells, TRECs, and thymic volume. The initial net
increases in naïve T cells and TREC counts were significantly
correlated. Changes in thymic volume and TRECs were also indirectly
related; splitting the population into 2 groups of high and low
baseline TREC levels, only the group with low TREC levels had
significant increases in both TRECs and thymic volume. Thus, the
increase in thymic volume might be functional, in response to depleted TREC levels. Taken together, our data strongly suggest a thymic role in
immune reconstitution, at least in patients with depleted baseline TREC levels.
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