Abstract
The hallmark of HIV-1/simian immunodeficiency virus infections is the progressive depletion of CD4+ T cells that ultimately renders the host incapable of defending against AIDS-defining opportunistic infections and malignancies. Although many potential mechanisms have been proposed to explain CD4+ T-cell loss, this review focuses on the growing evidence that collagen deposition and consequent fibrotic damage to the lymphatic tissue T-cell compartment contributes to CD4+ T-cell decline and limits CD4+ T-cell repopulation, even with highly active antiretroviral therapy.
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References and Recommended Reading
Joint United Nations Programme on HIV/AIDS (UNAIDS): 2006 Report on the Global AIDS Epidemic 2006. Geneva: UNAIDS; 2006.
Burgoyne RW, Tan DH: Prolongation and quality of life for HIV-infected adults treated with highly active antiretroviral therapy (HAART): a balancing act. J Antimicrob Chemother 2008, 61:469–473.
Martin JC, Soriano V, Jimenez-Nacher I, et al.: Overall trends in CD4 counts and plasma viremia in an urban clinic since the introduction of highly active antiretroviral therapies. Clin Microbiol Infect 2001, 7:678–681.
Gea-Banacloche JC, Clifford Lane H: Immune reconstitution in HIV infection. AIDS 1999, 13(Suppl A):25–38.
Baker JV, Peng G, Rapkin J, et al.: Poor initial CD4+ recovery with antiretroviral therapy prolongs immune depletion and increases risk for AIDS and non-AIDS diseases. J Acquir Immune Defic Syndr 2008, 48:541–546.
Barbaro G, Barbarini G: HIV infection and cancer in the era of highly active antiretroviral therapy. Oncol Rep 2007, 17:1121–1126.
Engels EA, Biggar RJ, Hall HI, et al.: Cancer risk in people infected with human immunodeficiency virus in the United States. Int J Cancer 2008, 123:187–194.
Engels EA, Pfeiffer RM, Goedert JJ, et al.: Trends in cancer risk among people with AIDS in the United States 1980–2002. AIDS 2006, 20:1645–1654.
Grulich AE, van Leeuwen MT, Falster MO, Vajdic CM: Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet 2007, 370:59–67.
Lewden C, Salmon D, Morlat P, et al.: Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemiol 2005, 34:121–130.
Palefsky JM, Holly EA, Efirdc JT, et al.: Anal intraepithelial neoplasia in the highly active antiretroviral therapy era among HIV-positive men who have sex with men. AIDS 2005, 19:1407–1414.
O’Brien WA, Hartigan PM, Martin D, et al.: Changes in plasma HIV-1 RNA and CD4+ lymphocyte counts and the risk of progression to AIDS. Veterans Affairs Cooperative Study Group on AIDS. N Engl J Med 1996, 334:426–431.
Egger M, May M, Chene G, et al.: Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet 2002, 360:119–129.
Carpenter CC, Fischl MA, Hammer SM, et al.: Antiretroviral therapy for HIV infection in 1998: updated recommendations of the International AIDS Society-USA Panel. JAMA 1998, 280:78–86.
Dybul M, Fauci AS, Bartlett JG, et al.: Guidelines for using antiretroviral agents among HIV-infected adults and adolescents. Ann Intern Med 2002, 137:381–433.
Yeni PG, Hammer SM, Carpenter CC, et al.: Antiretroviral treatment for adult HIV infection in 2002: updated recommendations of the International AIDS Society-USA Panel. JAMA 2002, 288:222–235.
Bailey AC, Fisher M: Current use of antiretroviral treatment. Br Med Bull 2008, 87:175–192.
Vrisekoop N, van Gent R, de Boer AB, et al.: Restoration of the CD4 T cell compartment after long-term highly active antiretroviral therapy without phenotypical signs of accelerated immunological aging. J Immunol 2008, 181:1573–1581.
Hein WR: Organization of mucosal lymphoid tissue. Curr Top Microbiol Immunol 1999, 236:1–15.
Westermann J, Pabst R: Lymphocyte subsets in the blood: a diagnostic window on the lymphoid system? Immunol Today 1990, 11:406–410.
Brenchley JM, Price DA, Douek DC: HIV disease: fallout from a mucosal catastrophe? Nat Immunol 2006, 7:235–239.
Brenchley JM, Schacker TW, Ruff LE, et al.: CD4+ T cell depletion during all stages of HIV disease occurs predominantly in the gastrointestinal tract. J Exp Med 2004, 200:749–759.
Clayton F, Snow G, Reka S, Kotler DP: Selective depletion of rectal lamina propria rather than lymphoid aggregate CD4 lymphocytes in HIV infection. Clin Exp Immunol 1997, 107:288–292.
Guadalupe M, Reay E, Sankaran S, et al.: Severe CD4+ T-cell depletion in gut lymphoid tissue during primary human immunodeficiency virus type 1 infection and substantial delay in restoration following highly active antiretroviral therapy. J Virol 2003, 77:11708–11717.
Li Q, Duan L, Estes JD, et al.: Peak SIV replication in resting memory CD4+ T cells depletes gut lamina propria CD4+ T cells. Nature 2005, 434:1148–1152.
Mattapallil JJ, Douek DC, Hill B, et al.: Massive infection and loss of memory CD4+ T cells in multiple tissues during acute SIV infection. Nature 2005, 434:1093–1097.
Vajdy M, Veazey R, Tham I, et al.: Early immunologic events in mucosal and systemic lymphoid tissues after intrarectal inoculation with simian immunodeficiency virus. J Infect Dis 2001, 184:1007–1014.
Mehandru S, Poles MA, Tenner-Racz K, et al.: Lack of mucosal immune reconstitution during prolonged treatment of acute and early HIV-1 infection. PLoS Med 2006, 3:e484.
Chun TW, Nickle DC, Justement JS, et al.: Persistence of HIV in gut-associated lymphoid tissue despite long-term antiretroviral therapy. J Infect Dis 2008, 197:714–720.
Guadalupe M, Sankaran S, George MD, 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.
Estes J, Baker JV, Brenchley JM, et al.: Collagen deposition limits immune reconstitution in the gut. J Infect Dis 2008, 198:456–464.
George MD, Reay E, Sankaran S, Dandekar S: Early antiretroviral therapy for simian immunodeficiency virus infection leads to mucosal CD4+ T-cell restoration and enhanced gene expression regulating mucosal repair and regeneration. J Virol 2005, 79:2709–2719.
Verhoeven D, Sankaran S, Silvey M, Dandekar S: Antiviral therapy during primary simian immunodeficiency virus infection fails to prevent acute loss of CD4+ T cells in gut mucosa but enhances their rapid restoration through central memory T cells. J Virol 2008, 82:4016–4027.
O’Murchadha MT, Wolf BC, Neiman RS: The histologic features of hyperplastic lymphadenopathy in AIDS-related complex are nonspecific. Am J Surg Pathol 1987, 11:94–99.
Estes JD, Wietgrefe S, Schacker T, et al.: Simian immunodeficiency virus-induced lymphatic tissue fibrosis is mediated by transforming growth factor beta 1-positive regulatory T cells and begins in early infection. J Infect Dis 2007, 195:551–561.
Schacker TW, Brenchley JM, Beilman GJ, et al.: Lymphatic tissue fibrosis is associated with reduced numbers of naive CD4+ T cells in human immunodeficiency virus type 1 infection. Clin Vaccine Immunol 2006, 13:556–560.
Schacker TW, Nguyen PL, Beilman GJ, et al.: Collagen deposition in HIV-1 infected lymphatic tissues and T cell homeostasis. J Clin Invest 2002, 110:1133–1139.
Schacker TW, Reilly C, Beilman GJ, et al.: Amount of lymphatic tissue fibrosis in HIV infection predicts magnitude of HAART-associated change in peripheral CD4 cell count. AIDS 2005, 19:2169–2171.
Tsakraklides V, Tsakraklides E, Good RA: An autopsy study of human axillary lymph node histology. Am J Pathol 1975, 78:7–22.
Taniguchi I, Murakami G, Sato A, et al.: Lymph node hyalinization in elderly Japanese. Histol Histopathol 2003, 18:1169–1180.
Pahlavani MA, Richardson A, Cheung HT: Age-dependent changes of the mesenteric lymph node of Fischer F344 rats: morphological and histometric analysis. Mech Ageing Dev 1987, 39:137–146.
Cavert W, Notermans DW, Staskus K, et al.: Kinetics of response in lymphoid tissues to antiretroviral therapy of HIV-1 infection. Science 1997, 276:960–964.
Zhang ZQ, Notermans DW, Sedgewick G, et al.: Kinetics of CD4+ T cell repopulation of lymphoid tissues after treatment of HIV-1 infection. Proc Natl Acad Sci U S A 1998, 95:1154–1159.
Border WA, Noble NA: Transforming growth factor beta in tissue fibrosis. N Engl J Med 1994, 331:1286–1292.
Border WA, Ruoslahti E: Transforming growth factor-beta in disease: the dark side of tissue repair. J Clin Invest 1992, 90:1–7.
Mauviel A: Transforming growth factor-beta: a key mediator of fibrosis. Methods Mol Med 2005, 117:69–80.
Verrecchia F, Mauviel A: Transforming growth factor-beta and fibrosis. World J Gastroenterol 2007, 13:3056–3062.
Estes JD, Li Q, Reynolds MR, et al.: Premature induction of an immunosuppressive regulatory T cell response during acute simian immunodeficiency virus infection. J Infect Dis 2006, 193:703–712.
Azuma A, Nukiwa T, Tsuboi E, et al.: Double-blind, placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2005, 171:1040–1047.
Nagai S, Hamada K, Shigematsu M, et al.: Open-label compassionate use one year-treatment with pirfenidone to patients with chronic pulmonary fibrosis. Intern Med 2002, 41:1118–1123.
Nicod LP: Pirfenidone in idiopathic pulmonary fibrosis. Lancet 1999, 354:268–269.
Raghu G, Johnson WC, Lockhart D, Mageto Y: Treatment of idiopathic pulmonary fibrosis with a new antifibrotic agent, pirfenidone: results of a prospective, open-label phase II study. Am J Respir Crit Care Med 1999, 159:1061–1069.
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Estes, J.D. Role of collagen deposition in lymphatic tissues and immune reconstruction during HIV-1 and SIV infections. Curr HIV/AIDS Rep 6, 29–35 (2009). https://doi.org/10.1007/s11904-009-0005-0
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DOI: https://doi.org/10.1007/s11904-009-0005-0