Antiretroviral Treatment May Restore Thymic Function

Powerful antiretroviral therapy for HIV infection can help restore thymic function in treated patients, researchers in Spain report. "The origin of T cells after highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus 1 (HIV-1) is now under discussion," according to Dr. Jaime M. Franco and colleagues working at Virgen del Rocio University Hospital in Seville. "The possibility of renewed lymphopoiesis in aged thymuses is still controversial."

In their preliminary study, Franco and colleagues found evidence supporting the possibility of HAART-induced thymic restoration. The researchers evaluated thymic production of naive T cells and T-cell receptor excision circles (TRECs) in 15 volunteers who underwent a 48-week HAART regimen. None of these patients had received antiretroviral treatment prior to the study, they noted.

After 12 weeks of HAART, study participants showed significant elevations in their production of naive CD4 and CD8 cells. These increases were accompanied by gains in TREC generation and thymic volume, according to the report. However, increased thymic volume and TREC output were only significant in patients with low basal TREC levels ("T-Cell Repopulation And Thymic Volume in HIV-1-Infected Adult Patients After Highly Active Antiretroviral Therapy," Blood, May 2002;99(10):3702-3706).

"Taken together, our data strongly suggest a thymic role in immune reconstitution, at least in patients with depleted baseline TREC levels," Franco and colleagues concluded.

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