Virologic and immunologic effect of antiretroviral therapy on HIV-1 in gut-associated lymphoid tissue.
OBJECTIVE
We evaluated virologic and immunologic responses to antiretroviral therapy in gut-associated lymphoid tissue (GALT) compared with those found in peripheral blood.


METHODS
Eight HIV-1-infected individuals were treated with three reverse transcriptase inhibitors and one protease inhibitor. Endoscopic biopsies were performed at baseline, and at months 1, 2, and 6. We measured the level of cell-associated multiply spliced and unspliced HIV-1 mRNA in GALT and in peripheral blood mononuclear cells. Immunologic responses were assessed by flow cytometry.


RESULTS
Levels of multiply spliced HIV-1 mRNA declined in parallel fashion both in peripheral blood and GALT. After 6 months of therapy, unspliced HIV-1 mRNA in the GALT was below assay detection although it persisted in peripheral blood mononuclear cells in 4 study subjects. Although the percentage of CD4+ lymphocytes increased significantly in peripheral blood, only modest increases occurred in GALT. The percentage of activated CD8+ T cells decreased significantly in peripheral blood whereas only modest reductions occurred in GALT.


CONCLUSIONS
Antiretroviral therapy effectively suppressed HIV-1 replication in GALT. The percentage of CD4+ T cells in peripheral blood uniformly increased in all study subjects, whereas it was more variable in the GALT.
Talal
A H
AH
Aaron Diamond AIDS Research Center, New York City, New York, USA. aht2002@pop.med.cornell.edu
Monard
S
S
Vesanen
M
M
Zheng
Z
Z
Hurley
A
A
Cao
Y
Y
Fang
F
F
Smiley
L
L
Johnson
J
J
Kost
R
R
Markowitz
M H
MH
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002908:Chronic Disease; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000502:physiology; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology* / Q000821:virology*; D008221:Lymphoid Tissue / Q000276:immunology* / Q000821:virology*; D008297:Male; D010865:Pilot Projects; D012333:RNA, Messenger / Q000032:analysis / Q000097:blood / Q000235:genetics; D012367:RNA, Viral / Q000032:analysis / Q000097:blood / Q000235:genetics; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000276:immunology / Q000821:virology; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy / Q000276:immunology / Q000821:virology
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D012333:RNA, Messenger; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors