title: Lymphoid fibrosis occurs in long-term nonprogressors and persists with antiretroviral therapy but may be reversible with curative interventions.
abstract: Human immunodeficiency virus (HIV) replication causes lymphoid tissue (LT) fibrosis, which causes CD4(+) T-cell depletion. It is unknown whether people who spontaneously control HIV replication have LT fibrosis. We measured LT fibrosis and CD4(+) T cells in 25 HIV controllers, 10 noncontrollers, 45 HIV-positive individuals receiving therapy, and 10 HIV-negative individuals. Controllers had significant LT fibrosis and CD4(+) T-cell depletion, similar to noncontrollers, but the so-called Berlin patient (in whom HIV infection was cured) had near normal LT. Thus, LT fibrosis occurs in all HIV-infected subjects, and current therapy does not reverse it. Reversal of fibrosis during a curative intervention suggests that ongoing low-level virus production may maintain LT fibrosis.
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Joyce L
authors.initials: JL
authors.lastname: Sanchez
authors.affiliation: University of California, San Francisco.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hunt
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Cavan S
authors.initials: CS
authors.lastname: Reilly
authors.affiliation: University of California, San Francisco.
authors.forename: Hiroyu
authors.initials: H
authors.lastname: Hatano
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Beilman
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Alexander
authors.initials: A
authors.lastname: Khoruts
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Jake S
authors.initials: JS
authors.lastname: Jasurda
authors.affiliation: University of California, San Francisco.
authors.forename: Ma
authors.initials: M
authors.lastname: Somsouk
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Ann
authors.initials: A
authors.lastname: Thorkelson
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Samuel
authors.initials: S
authors.lastname: Russ
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Jodi
authors.initials: J
authors.lastname: Anderson
authors.affiliation: University of California, San Francisco.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Deeks
authors.affiliation: University of Minnesota, Minneapolis.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Schacker
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000821:virology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005355:Fibrosis; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D020276:HIV Long-Term Survivors; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008221:Lymphoid Tissue / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000473:pathology; D014779:Virus Replication
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; HIV controllers; fibrosis