title: Recent Thymus Emigrant CD4+ T Cells Predict HIV Disease Progression in Patients With Perinatally Acquired HIV.
abstract: BACKGROUND
  Robust immune restoration in human immunodeficiency virus (HIV)-positive patients is dependent on thymic function. However, few studies have investigated thymic function and its correlation with disease progression over time in HIV-positive patients.
  
  
  METHODS
  In this longitudinal prospective study, we followed 69 HIV-positive patients who were perinatally infected. Peripheral blood mononuclear cells were stained with monoclonal anti-CD4 and anti-CD31 and recent thymic emigrants (CD4+recently emigrated from the thymus (RTE), CD4+CD31+) quantified by flow cytometry. Statistical analysis used Wilcoxon rank sum test, Kruskal-Wallis, Spearman correlation, and Kaplan-Meier estimates; Cox regression models were performed for the longitudinal analysis.
  
  
  RESULTS
  Median age of HIV positive patients enrolled was 13 years (interquartile range [IQR], 8.6). CD4+RTE% decreased with age and was higher in females. Median CD4+RTE% was 53.5%, IQR, 22.9. CD4+RTE% was closely related to CD4+% and absolute counts but independent of viral load and CD8+CD38+%. Antiretroviral compliance as well as higher nadir CD4+% were associated with higher CD4+RTE%. Low CD4+RTE% predicted poor progression of VL and CD4+% over time.
  
  
  CONCLUSIONS
  CD4+RTE% predicts disease progression and may reflect history of disease in HIV-positive patients and adolescents. They are easy to measure in the clinical setting and may be helpful markers in guiding treatment decisions.
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Ramia
authors.initials: R
authors.lastname: Zakhour
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Dat Q
authors.initials: DQ
authors.lastname: Tran
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Guenet
authors.initials: G
authors.lastname: Degaffe
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Bell
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Donnachie
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Weihe
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Norma
authors.initials: N
authors.lastname: Pérez
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Benjamins
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Del Bianco
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Gilhen
authors.initials: G
authors.lastname: Rodriguez
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: James R
authors.initials: JR
authors.lastname: Murphy
authors.affiliation: Department of Pediatrics, University of Texas Health Center, Houston, Texas.
authors.forename: Gloria P
authors.initials: GP
authors.lastname: Heresi
mesh_terms: D000293:Adolescent; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology / Q000502:physiology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008137:Longitudinal Studies; D008297:Male; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000276:immunology; D011247:Pregnancy; D011446:Prospective Studies; D013781:Texas / Q000453:epidemiology; D013950:Thymus Gland / Q000166:cytology / Q000276:immunology*; D019562:Viral Load; D055815:Young Adult
chemical_list: D019408:Platelet Endothelial Cell Adhesion Molecule-1
keywords: CD31; HIV; patients; thymus