title: Major influence of CD4 count at the initiation of cART on viral and immunological reservoir constitution in HIV-1 infected patients.
abstract: A persistent immune activation is observed in gut during HIV-1 infection, which is not completely reversed by a combined antiretroviral therapy (cART). The impact of the time of cART initiation may highly influence the size of the viral reservoir and the ratio of CD4(+)/CD8(+) T cells in the gut. In this study, we analyzed the characteristics of HIV rectal reservoir of long-term treated patients, regarding their blood CD4(+) T cells count at the time of cART initiation.
  
  
  
  Twenty-four consenting men were enrolled: 9 exhibiting a CD4(+) T cells count >350/mm(3) ("high-level CD4 group") and 15 < 350/mm(3) ("low-level CD4 group") in blood, at the start of cART. An immunophenotypical analysis of T and B cells subpopulations was performed in blood and rectal biopsies. HIV cell-associated DNA loads and qualitative intra-cellular RNA were determined in both compartments. The ratio of CD4(+)/CD8(+) T cells was significantly decreased in the blood but not in the rectum of the "low-level CD4 group" of patients. The alteration in β7(+) CD4(+) T cells homing was higher in this group and was correlated to a low ratio of CD4(+)/CD8(+) T cells in blood. An initiation of cART in men exhibiting a low-level CD4 count was also associated with an alteration of B cells maturation. HIV blood and gut DNA reservoirs were significantly lower in the "high-level CD4 group" of men. A high HIV DNA level was associated to a detectable intracellular HIV RNA in rectum.
  
  
  
  An early initiation of cART could significantly preserve gut immunity and limit the viral reservoir constitution.
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Laboratoire d'Immunologie, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Anne-Emmanuelle
authors.initials: AE
authors.lastname: Depincé-Berger
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Vergnon-Miszczycha
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Girard
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Frésard
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Botelho-Nevers
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Laboratoire d'Immunologie, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Lambert
authors.affiliation: Service d'Hépato-Gastroentérologie, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Del Tedesco
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Laboratoire d'Immunologie, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Genin
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Service des Agents Infectieux et d'Hygiène, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pozzetto
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lucht
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Service d'Hépato-Gastroentérologie, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Roblin
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France. thomas.bourlet@chu-st-etienne.fr.|Service des Agents Infectieux et d'Hygiène, Centre Hospitalo-Universitaire, Saint-Étienne, France. thomas.bourlet@chu-st-etienne.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bourlet
authors.affiliation: Groupe Immunité des Muqueuses et Agents Pathogènes - GIMAP EA 3064, CIC 1408, Faculté de Médecine J. Lisfranc, Université de Saint-Etienne, Université de Lyon, 42023, Saint-Étienne Cedex 02, France.|Laboratoire d'Immunologie, Centre Hospitalo-Universitaire, Saint-Étienne, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Paul
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D004279:DNA, Viral / Q000097:blood; D041981:Gastrointestinal Tract / Q000276:immunology* / Q000821:virology; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology / Q000502:physiology; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000302:isolation & purification; D012007:Rectum / Q000276:immunology / Q000821:virology; D061665:Time-to-Treatment; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral
keywords: GALT; HIV; Homing; Reservoir; cART