Lymphoid Fibrosis Occurs in Long-Term Nonprogressors and Persists With Antiretroviral Therapy but May Be Reversible With Curative Interventions

Human immunodeficiency virus (HIV) replication causes lymphoid tissue (LT) fibrosis, which causes CD4⁺ Tcell depletion. It is unknown whether people who spontaneously control HIV replication have LT fibrosis. We measured LT fibrosis and CD4⁺ T cells in 25 HIV controllers, 10 noncontrollers, 45 HIV-p...

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Bibliographic Details
Published in:The Journal of infectious diseases 2015-04, Vol.211 (7), p.1068-1075
Main Authors: Sanchez, Joyce L., Hunt, Peter W., Reilly, Cavan S., Hatano, Hiroyu, Beilman, Gregory J., Khoruts, Alexander, Jasurda, Jake S., Somsouk, Ma, Thorkelson, Ann, Russ, Samuel, Anderson, Jodi, Deeks, Steven G., Schacker, Timothy W.
Format: Article
Language:English
Subjects:
Adult
Anti-Retroviral Agents - therapeutic use
Biopsy
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes - virology
Cohort Studies
Disease Progression
Female
Fibrosis
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - pathology
HIV Infections - virology
HIV Long-Term Survivors
HIV-1 - drug effects
HIV-1 - physiology
HIV/AIDS
Human immunodeficiency virus
Humans
Longitudinal Studies
Lymphoid Tissue - pathology
Major and Brief Reports
Male
Middle Aged
Rectum - pathology
Virus Replication
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Summary:Human immunodeficiency virus (HIV) replication causes lymphoid tissue (LT) fibrosis, which causes CD4⁺ Tcell depletion. It is unknown whether people who spontaneously control HIV replication have LT fibrosis. We measured LT fibrosis and CD4⁺ T cells in 25 HIV controllers, 10 noncontrollers, 45 HIV-positive individuals receiving therapy, and 10 HIV-negative individuals. Controllers had significant LT fibrosis and CD4⁺ T-cell depletion, similar to noncontrollers, but the so-called Berlin patient (in whom HIV infection was cured) had near normal LT. Thus, LT fibrosis occurs in all HIV-infected subjects, and current therapy does not reverse it. Reversal of fibrosis during a curative intervention suggests that ongoing low-level virus production may maintain LT fibrosis.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jiu586