Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 185, Issue 11, Pages 1578-1585Publisher
OXFORD UNIV PRESS INC
DOI: 10.1086/340418
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To examine the impact of thymic size on immune recovery in patients with human immunodeficiency virus (HIV) infection, the thymus was visualized, using computed tomographic scans, in 25 HIV-infected patients who had received highly active antiretroviral therapy (HAART) for 6-18 months and had levels of viremia, <500 copies/mL. For comparison, 10 control subjects were included in the study. Total and naive CD4(+) cell counts were determined by flow cytometry. To determine thymic output, the number of CD4(+) cells containing T cell receptor excision circles (TRECs) was measured. Qualitative immune recovery was evaluated by determination of CD4(+) T cell receptor repertoire in 19 of the HIV-infected patients. Larger thymic size was associated with higher CD4(+) cell counts (r=0.498; P=.011) and higher CD4(+) TREC frequency (r=0.652; P<.001). Furthermore, patients with abundant thymic tissue seemed to have broader immunologic repertoires, compared with patients with minimal thymic tissue (P=.054). These findings suggest that thymopoiesis is ongoing in the adult thymus and contributes to immune reconstitution in HIV-infected patients receiving HAART.
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