CD4 T cells remain the major source of HIV-1 during end stage disease

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Abstract
Objective: To assess the source of HIV-1 production in lymphoid tissue biopsies from HIV-infected patients, with no prior anti-retroviral protease inhibitor treatment, with a CD4 cell count >150¥106/l (group I) or 6/l (group II), co-infected with Mycobacterium tuberculosis or Mycobacterium avium complex. Design and methods: Lymphoid tissue biopsies from 11 HIV-1-infected patients, taken for diagnostic purposes, were studied by HIV-1 RNA in situ hybridization and immunohistochemistry. Results: Patients of group I showed well organized granulomas, in contrast with patients of group II, in which granuloma formation was absent. HIV-1 RNA-positive cells in group I patients were found mainly around the granulomas, whereas in group II HIV-1-producing cells were confined to areas with remaining intact lymphoid tissue. Despite the abundant presence of macrophages, the productively infected HIV-1-positive cells in both groups were almost exclusively CD4 T cells. Conclusion: In contrast with previously published data, CD4 T cells appear to remain the major source of HIV-1 production in end-stage disease.