Effect of combination antiretroviral therapy upon rectal mucosal HIV RNA burden and mononuclear cell apoptosis.
BACKGROUND
Pathogen-negative diarrhea is common in HIV infection and has been associated with clinical symptoms, histopathology, HIV expression, CD4+ lymphocyte depletion, cytokine mRNA expression, and apoptosis of lamina propria mononuclear cells.


OBJECTIVE
To examine the short-term (7-day) effects of treatment with combination antiretroviral therapies upon gastrointestinal symptoms and rectal mucosa in 15 HIV-infected subjects.


RESULTS
Treatment was associated with significant decreases in the perception of abdominal bloating and cramps. Similar declines in RNA burden and rises in CD4+ lymphocyte counts were found in blood and mucosa. Treatment was also associated with a fall in the number of lamina propria mononuclear cells undergoing apoptosis by in situ labeling, a change that correlated with the change in mucosal viral burden.


CONCLUSIONS
Peripheral blood and mucosal compartments are equally responsive to effective antiretroviral therapies. The detection of significant changes within 7 days of starting antiviral therapy implies that intestinal dysfunction may be a direct result of local HIV infection.
Kotler
D P
DP
Department of Medicine, St Luke's-Roosevelt Hospital Center, Columbia College of Physicians and Surgeons, New York, New York 10025, USA.
Shimada
T
T
Snow
G
G
Winson
G
G
Chen
W
W
Zhao
M
M
Inada
Y
Y
Clayton
F
F
D019380:Anti-HIV Agents / Q000008:administration & dosage*; D017209:Apoptosis / Q000276:immunology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D003085:Colic / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy; D016655:HIV Core Protein p24 / Q000032:analysis / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology / Q000503:physiopathology / Q000821:virology*; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis* / Q000097:blood; D019562:Viral Load
D019380:Anti-HIV Agents; D016655:HIV Core Protein p24; D012367:RNA, Viral