title: Factors associated with collagen deposition in lymphoid tissue in long-term treated HIV-infected patients.
abstract: OBJECTIVE
  The factors associated with fibrosis in lymphoid tissue in long-term treated HIV-infected patients and their correlation with immune reconstitution were assessed.
  
  
  METHODS
  Tonsillar biopsies were performed in seven antiretroviral-naive patients and 29 successfully treated patients (median time on treatment, 61 months). Twenty patients received protease inhibitors-sparing regimens and nine protease inhibitor-containing regimens. Five tonsillar resections of HIV-negative individuals were used as controls. Lymphoid tissue architecture, collagen deposition (fibrosis) and the mean interfollicular CD4(+) cell count per mum were assessed.
  
  
  RESULTS
  Naive and long-term treated HIV-infected patients had a higher proportion of fibrosis than did HIV-uninfected persons (P < 0.001). Patients with greater collagen deposition showed lower levels of CD4 cells in lymphoid tissue (P = 0.03) and smaller increase in peripheral CD4(+) T cells (r = -0.40, P = 0.05). The factors independently associated with fibrosis in lymphoid tissue were age (P < 0.0001), treated patients with detectable lymphoid tissue viral load when compared with patients with undetectable lymphoid tissue viral load (median 5 vs. 12%, respectively, P = 0.017) and patients receiving a protease inhibitor-sparing vs. a protease inhibitor-containing regimen (median 8 vs. 2.5%, respectively, P = 0.04).
  
  
  CONCLUSIONS
  Fibrosis in lymphoid tissue was associated with a poor reconstitution of CD4(+) T cells and long-term antiretroviral therapy did not reverse this abnormality. HIV infection, older age, a detectable level of lymphoid tissue viral load in treated patients and protease inhibitor-sparing regimens seem to favour fibrosis in lymphoid tissue.
authors.affiliation: Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Diaz
authors.forename: Llúcia
authors.initials: L
authors.lastname: Alós
authors.forename: Agathe
authors.initials: A
authors.lastname: León
authors.forename: Anna
authors.initials: A
authors.lastname: Mozos
authors.forename: Miguel
authors.initials: M
authors.lastname: Caballero
authors.forename: Antonio
authors.initials: A
authors.lastname: Martinez
authors.forename: Montserrat
authors.initials: M
authors.lastname: Plana
authors.forename: Teresa
authors.initials: T
authors.lastname: Gallart
authors.forename: Cristina
authors.initials: C
authors.lastname: Gil
authors.forename: Manuel
authors.initials: M
authors.lastname: Leal
authors.forename: Jose M
authors.initials: JM
authors.lastname: Gatell
authors.forename: Felipe
authors.initials: F
authors.lastname: García
mesh_terms: D000328:Adult; D000375:Aging / Q000276:immunology / Q000378:metabolism*; D018791:CD4 Lymphocyte Count; D003094:Collagen / Q000276:immunology / Q000378:metabolism*; D005260:Female; D005355:Fibrosis; D015658:HIV Infections / Q000276:immunology / Q000473:pathology* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014066:Palatine Tonsil / Q000473:pathology* / Q000821:virology; D012307:Risk Factors; D019562:Viral Load
chemical_list: D003094:Collagen