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early treatment and hiv-specific T cells
Aug 17, 2002

Dear Dr. Young,

I have read about the studies of Walker et al. with great interest, and I think their data encourages earliest-possible treatment.

One of the easy-to-grasp aspects is that it simply disallows the virus to satuarate all possible reservoirs of the body.

However I do not (yet) understand the other reason for early treatment: "preservation of HIV-specific T- helper cells".

My questions are:

*) the bone marrow/thymus constantly produces T-cells of all kinds of specificity. So how come that the body "runs out" of HIV specific T-cells, assuming that these cells are generated completely by chance (i.e. indepent of sero-status of the subject?)

*) is the reason for this that the HIV specific T-cells are produced over many years and cannot be replaced in short term once destroyed (especially if a constant level of HIV virema is present, killing all "new born" hiv specific T cells)?

*) If so, what hope can be given to chronical infected people? - Is cloning of HIV specific T-cells subject of investigation? is this necessarily - what other investigations are going on?

thank you very much for sharing your great knowledge!


Response from Dr. Young

Thanks for your thoughtful question.

I think that the simple answer is that while there is a steady production of T cells, these T cells do not represent a new set of cells, but rather clones of preexisting cells. The immunological diversity or repetoir of the T cells is not, contrary to your statement, continually increasing; hence, what happens early in HIV infection, as specific deficit in the diversity occurs. The concern is that this specific deletion comes from the very cells with the greatest ability to recognize HIV.

Hope this helps, BY

Starting meds and sobriety

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