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Early treatment does not protect CD4s in gut
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A report from the XVI International AIDS Conference
Toronto, August 13-18, 2006
Extract from IAC Report 4 on Treating Primary Infection
Mark Mascolini
Shielding critical CD4 cells from early annihilation by HIV remains an attractive rationale for rapid treatment of early infection. But a study of two groups promptly treated at New YorkÕs Aaron Diamond AIDS Research Center found that fast treatment that continues for years did not protect gut T cells from HIV or restore them to normal levels [10].
With colleagues at other site, Saurabh Mehandru studied two groups:
- Eighteen people with acute or early HIV infection followed prospectively during 3 years of antiretroviral therapy.
- Twenty-two people diagnosed with acute or early HIV infection and followed after 1, 1 to 3, or 3 to 7 years of treatment.
Mehandru compared rectosigmoid colon biopsies from these people with biopsies from 18 people without HIV infection. Whereas the 18 uninfected people had equivalent CD4 tallies in peripheral blood and colon, the HIV-infected groups had persistently lower CD4 counts in the colon regardless of how long they took antiretrovirals. These results mirror findings of another study published during the Toronto meeting [11].
References
10. Mehandru S, Poles M, Tenner-Racz K, et al. Gastrointestinal immune reconstitution is delayed and incomplete after initiation of antiretroviral therapy during acute HIV-1 infection. XVI International AIDS Conference. August 13-18, 2006. Toronto. Abstract TUPE0033.
11. Guadalupe M, Sankaran S, George M, et al. Viral suppression and immune restoration in the gastrointestinal mucosa of human immunodeficiency virus type 1-infected patients initiating therapy during primary or chronic infection. J Virol 2006;80:8236-8247.
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