Official websites use. Share sensitive information only on official, secure websites. Corresponding author. Phone: Fax: E-mail: jmattapallil usuhs. The rectal mucosa is a major site for human immunodeficiency virus entry and CD4 T-cell depletion. The early and near-total loss of these cells from the rectal mucosa severely compromises the ability of the mucosal immune system to control various opportunistic infections.
Protecting these cells from infection and destruction can delay disease progression, leading to a better long-term outcome. Here we show that effective suppression of viral infection in memory CD4 T cells from the rectal mucosa and peripheral blood to a very low level with antiretroviral therapy ART initiated prior to the peak of infection is associated with opposite outcomes in these tissues. A near-total loss of CD4 T cells in the rectal mucosa contrasted with preservation of most memory CD4 T cells in peripheral blood during the course of treatment.
Interestingly, ART significantly reduced viral infection in memory CD4 T cells from both rectal mucosa and peripheral blood. Although early ART was of limited value in protecting the CD4 T cells in the rectal mucosa, the significant preservation of peripheral CD4 T cells could contribute to maintaining immune competence, leading to a better long-term outcome. These cells are rapidly infected and destroyed within the first few weeks after infection 14 , 17 , Protecting these cells from infection and subsequent destruction during the acute phase of infection can have a significant potential long-term benefit.
Little is known, however, about the ability of antiretroviral therapy ART to contain viral infection in memory CD4 T cells and to preserve them during the early acute phase of infection. More importantly, little is known about whether ART can have a significant benefit in mucosal tissues.
Studies to date using long-term highly active antiretroviral therapy HAART have shown that viral replication continues, and CD4 T cells fail to repopulate the mucosa even after 10 years of continuous HAART 1 , 3 , 8 , 12 , 13 , 18 , 22 , 25 , Previous studies 14 , 17 showed that viral infection of CD4 T cells in peripheral and mucosal tissues peaked around 10 days after simian immunodeficiency virus SIV challenge.
