Preferential and persistent depletion of CCR5+ T-helper lymphocytes with nonlymphoid homing potential despite early treatment of primary HIV infection

Strains of human immunodeficiency virus (HIV) transmitted between individuals use the CCR5 coreceptor, but no preferential depletion of particular Thlymphocyte subpopulations has been reported during primary HIV infection (PHI). In contrast, gut-associated Th lymphocytes are preferentially depleted in macaques recently infected by simian immunodeficiency virus. The expression of CCR5 and the intestinal homing receptor integrin alpha (4)beta (7) on subpopulations of Th lymphocytes was studied in 12 patients with PHI. There was a profound decrease of circulating alpha (4)beta (+)(7) lymphocytes and CCR5(+) memory Th lymphocytes with nonlymphoid homing potential (CD62L(-)CD45RO(+)). Unlike other Th lymphocytes, this cell population remained depleted despite early control of viral replication under antiretroviral treatment. Therefore, HIV preferentially targets a specific CCR5(+) subpopulation of Th lymphocytes early during infection, inducing its persistent depletion despite treatment. Protective immunity in vivo depends on Th lymphocytes carrying homing capacity to non-lymphoid tissue, and therefore these data may explain the persistent abnormalities of immune functions in patients infected with HIV. (C) 2001 by The American Society of Hematology.