Early initiation of combined antiretroviral therapy preserves immune function in the gut of HIV-infected patients - Archive ouverte HAL Access content directly
Journal Articles Mucosal Immunology Year : 2015

Early initiation of combined antiretroviral therapy preserves immune function in the gut of HIV-infected patients

Henri Bonnabau
  • Function : Author
  • PersonId : 1013812
Rodolphe Thiébaut

Abstract

Massive loss of lamina propria CD4+ T cells, changes in the lymphatic architecture, and altered intestinal epithelial barrier leading to microbial translocation are the common features of HIV-1 infection and are not fully restored under combined antiretroviral therapy (cART). To better understand determinants of gut mucosal restoration, we have performed phenotypic and gene expression analyses of the gut from HIV-infected patients, naive or treated with cART initiated either at the early phase of the primary infection or later during the chronic phase. We found a depletion of T helper type 22 (Th22) and interleukin-17-producing cells in naive patients. These populations, except Th22 cells, were not restored under cART. Regulatory T cells/Th17 ratio was significantly increased in HIV-infected patients and was inversely correlated to the restoration of CD4+ T cells but not to gut HIV DNA levels. Gene profile analysis of gut mucosal distinguished two groups of patients, which fitted with the timing of cART initiation. In their majority early, but not later treated patients, exhibited conserved intestinal lymphoid structure, epithelial barrier integrity and dendritic cell maturation pathways. Our data demonstrate that early initiation of cART helps to preserve and/or restore lymphoid gut mucosal homeostasis and provide a rationale for initiating cART during the acute phase of HIV infection.

Dates and versions

hal-01288851 , version 1 (15-03-2016)

Identifiers

Cite

Ayrin Kök, Laurent Hocqueloux, Hakim Hocini, Marie Carrière, Laurent Lefrou, et al.. Early initiation of combined antiretroviral therapy preserves immune function in the gut of HIV-infected patients. Mucosal Immunology, 2015, 8 (1), pp.127-140. ⟨10.1038/mi.2014.50⟩. ⟨hal-01288851⟩
149 View
0 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More