Important note: Information in this article was accurate in November 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; November 18, 2002
Michael Greer, Senior Medical Writer
Cristina Mussini and colleagues at the University of Modena and Azienda Ospedaliera Policlinico in Modena conducted a study to "identify crucial immunological characteristics of a group of patients, defined 'CD4-exploders', who were able to fully reconstitute their immune system after receiving highly active antiretroviral therapy (HAART)."
Interleukin (IL)-7 activity appeared to be the key factor in "CD4-explosion" after HAART initiation, Mussini and coauthors found.
The researchers identified six "CD4-exploders" out of a group of 540 HAART-treated patients. These six patients had CD4 cell counts of less than 85 x 106 CD4 cells/L before treatment, and four had suffered major opportunistic infections prior to HAART, according to the report.
IL-7 levels were significantly elevated in CD4-exploders compared with their counterparts, study data showed. In addition, IL-7 receptor alpha was significantly upregulated on CD8+ T cells from these patients.
Despite high levels of new T cells containing T-cell receptor rearrangement excision circles (TREC), intrathymic lymphoid tissue was profoundly depleted in CD4-exploders (Features of 'CD4-exploders', HIV-positive patients with an optimal immune reconstitution after potent antiretroviral therapy. AIDS 2002 Aug 16;16(12):1609-16.
"In 'CD4-exploders', HAART-induced reconstitution of the T-cell compartment is independent from thymus volume, and is favoured by the upregulation of the IL-7/IL-7 receptor system," Mussini and colleagues concluded.
The corresponding author for this report is Andrea Cossarizza, University of Modena, Reggio Emilia School of Medicine, Dept. of Biomedical Science, Section of General Pathology, via Campi 287, I-41100 Modena, Italy.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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