Kolte L, Ryder L P, Albrecht-Beste E, Jensen Frank K, Nielsen S D
Department of Infectious Diseases, 144, Copenhagen University Hospital, Hvidovre, 2650 Hvidovre, Denmark.
Scand J Immunol. 2009 Dec;70(6):608-13. doi: 10.1111/j.1365-3083.2009.02328.x.
CD4 recovery in HIV-infected patients treated with highly active antiretroviral therapy (HAART) is in part believed to be dependent on the degree of preserved thymic function. We investigated whether the thymus has a prolonged effect on CD4 recovery. Total and naïve CD4 counts as well as thymic output determined as the number of CD4 + cells containing T-cell receptor-rearrangement excision DNA circles were measured prospectively in 25 HIV-infected patients with known thymic size during 5 years of HAART. Patients with larger thymic size had at all time points of follow-up significantly higher CD4 counts than patients with minimal thymic size (P = 0.0036). The CD4 increase from time of initiation of HAART until 6 months of follow-up differed significantly between the two thymic groups (P = 0.045), but did not at later time points. Thymic output remained significantly higher in patients with larger thymic size at follow-up. However, no difference in the increase in thymic output was seen between thymic groups. In conclusion, the importance of the thymus to the rate of cellular restoration seems primarily to lie within the first two years of HAART. However, patients with larger thymic size are able to maintain higher CD4 counts even after 5 years of HAART.
人们认为，接受高效抗逆转录病毒疗法（HAART）治疗的HIV感染患者的CD4恢复在一定程度上取决于胸腺功能保留的程度。我们研究了胸腺对CD4恢复是否有长期影响。在25名已知胸腺大小的HIV感染患者接受HAART治疗的5年期间，前瞻性地测量了总CD4计数和初始CD4计数，以及作为含有T细胞受体重排切除DNA环的CD4 +细胞数量测定的胸腺输出。在随访的所有时间点，胸腺较大的患者的CD4计数明显高于胸腺最小的患者（P = 0.0036）。从开始HAART到随访6个月，两组胸腺患者的CD4增加有显著差异（P = 0.045），但在后期时间点没有差异。随访时，胸腺较大的患者的胸腺输出仍然显著更高。然而，两组胸腺患者的胸腺输出增加没有差异。总之，胸腺对细胞恢复率的重要性似乎主要在于HAART治疗的头两年。然而，即使经过5年的HAART治疗，胸腺较大的患者仍能够维持较高的CD4计数。
