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reservoir in gut?
Jul 30, 2006

Hi there, just read an article on the BBC news website: Californian group showed the human gut is a reservoir. Though HAART may elevate CD4, cause drop in virusload in blood, it has less effect on HIV in the gut (i imagine they mean the human epithelian cells in the gut, not the faecal mass in there). They state that the hit hard hit early method of HAART may be better than waiting for a few years until CD4 drops/VL increases, as the damage to the gut and the extent of HIV presence in the gut is less pronounced when starting right after/during seroconversion. Any thoughts?

Response from Dr. Wohl

It is now well appreciated that there are many places in the body that can serve as 'reservoirs' for HIV. Gut associated lymphoid tissue (GALT) is one such compartment. GALT is rich in immune cells that work to protect us from the things we ingest. GALT is in the wall of our intestines and like lymph nodes can harbor CD4 and other cells that are infected with the virus. These cells are infected as HIV travels through teh blood and lymph system.

The presence of these reservoirs of virus has prompted some to call for early HIV therapy in an attempt to limit the size of these infected pools of cells. Others caution that these reservoirs may be established very early in infection and that unless treatment is started within days to weeks of infection there may be little effect of therapy on the establishment or extent of GALT and other infected compartments.

DW



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