The Role of the Thymus in Immunologic Nonresponse to Suppressive ART

Reduced thymic output may be playing a role in the failure of patients to achieve immune reconstitution.

Suboptimal CD4-cell recovery despite long-term suppressive antiretroviral therapy (ART) has been linked to elevated levels of immune activation (JW AIDS Clin Care Oct 24 2011). Now, a detailed analysis suggests that reduced thymic output may also be playing a role.

Researchers at a Beijing clinic followed 74 patients for 3 to 7 years after the initiation of ART. Of the 39 who had good virologic response, 13 were found to be immunologic nonresponders; that is, they had CD4 counts <200 cells/mm³ (or <20% restoration compared with baseline) despite maintaining undetectable viral loads for at least 12 months. For comparison, these patients were matched with 17 immunologic responders (CD4 counts >300 cells/mm³ or >30% restoration) based on age, s…

Reviewing Author

Rajesh T. Gandhi, MD

The Role of the Thymus in Immunologic Nonresponse to Suppressive ART

Topics

Reviewing Author