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. 2016 Apr 15;62(8):1029-1035.
doi: 10.1093/cid/ciw030. Epub 2016 Feb 21.

Recent Thymus Emigrant CD4+ T Cells Predict HIV Disease Progression in Patients With Perinatally Acquired HIV

Ramia Zakhour  1 , Dat Q Tran  1 , Guenet Degaffe  1 , Cynthia S Bell  1 , Elizabeth Donnachie  1 , Weihe Zhang  1 , Norma Pérez  1 , Laura J Benjamins  1 , Gabriela Del Bianco  1 , Gilhen Rodriguez  1 , James R Murphy  1 , Gloria P Heresi  1
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Recent Thymus Emigrant CD4+ T Cells Predict HIV Disease Progression in Patients With Perinatally Acquired HIV

Ramia Zakhour et al. Clin Infect Dis. .

Abstract

Background: Robust immune restoration in human immunodeficiency virus (HIV)-positive patients is dependent on thymic function. However, few studies have investigated thymic function and its correlation with disease progression over time in HIV-positive patients.

Methods: In this longitudinal prospective study, we followed 69 HIV-positive patients who were perinatally infected. Peripheral blood mononuclear cells were stained with monoclonal anti-CD4 and anti-CD31 and recent thymic emigrants (CD4+recently emigrated from the thymus (RTE), CD4+CD31+) quantified by flow cytometry. Statistical analysis used Wilcoxon rank sum test, Kruskal-Wallis, Spearman correlation, and Kaplan-Meier estimates; Cox regression models were performed for the longitudinal analysis.

Results: Median age of HIV positive patients enrolled was 13 years (interquartile range [IQR], 8.6). CD4+RTE% decreased with age and was higher in females. Median CD4+RTE% was 53.5%, IQR, 22.9. CD4+RTE% was closely related to CD4+% and absolute counts but independent of viral load and CD8+CD38+%. Antiretroviral compliance as well as higher nadir CD4+% were associated with higher CD4+RTE%. Low CD4+RTE% predicted poor progression of VL and CD4+% over time.

Conclusions: CD4+RTE% predicts disease progression and may reflect history of disease in HIV-positive patients and adolescents. They are easy to measure in the clinical setting and may be helpful markers in guiding treatment decisions.

Keywords: CD31; HIV; patients; thymus.

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Figures

Figure 1.
Figure 1.
A and B, Significant predictors of deterioration: patients transitioning from better than clinically poor status (Cpoor) at baseline to Cpoor during follow-up. (C and D), Significant predictors of improvement: patients transitioning from less than clinically good status (Cgood) at baseline to Cgood during follow-up. Abbreviations: ART, antiretroviral therapy; cART, combined antiretroviral therapy; RTE, recently emigrated from the thymus.
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