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J Clin Invest. 1999 Feb;103(4):453-60.

Analysis of the adult thymus in reconstitution of T lymphocytes in HIV-1 infection.

Author information

1
Department of Medicine, Duke Center for AIDS Research, Duke University Medical Center, Durham, North Carolina 27710, USA. Hayne002@mc.duke.edu

Erratum in

  • J Clin Invest 1999 Mar;103(6):921.

Abstract

A key question in understanding the status of the immune system in HIV-1 infection is whether the adult thymus contributes to reconstitution of peripheral T lymphocytes. We analyzed the thymus in adult patients who died of HIV-1 infection. In addition, we studied the clinical course of HIV-1 infection in three patients thymectomized for myasthenia gravis and determined the effect of antiretroviral therapy on CD4(+) T cells. We found that five of seven patients had thymus tissue at autopsy and that all thymuses identified had inflammatory infiltrates surrounding lymphodepleted thymic epithelium. Two of seven patients also had areas of thymopoiesis; one of these patients had peripheral blood CD4(+) T-cell levels of <50/mm3 for 51 months prior to death. Of three thymectomized patients, one rapidly progressed to AIDS, one progressed to AIDS over seven years (normal progressor), whereas the third remains asymptomatic at least seven years after seroconversion. Both latter patients had rises in peripheral blood CD4(+) T cells after antiretroviral therapy. Most patients who died of complications of HIV-1 infection did not have functional thymus tissue, and when present, thymopoiesis did not prevent prolonged lymphopenia. Thymectomy before HIV-1 infection did not preclude either peripheral CD4(+) T-cell rises or clinical responses after antiretroviral therapy.

PMID:
10021452
PMCID:
PMC408098
DOI:
10.1172/JCI5201
[Indexed for MEDLINE]
Free PMC Article

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