@article{10.1172/jci.insight.87065, author = {Claire Deleage AND Alexandra Schuetz AND W. Gregory Alvord AND Leslie Johnston AND Xing-Pei Hao AND David R. Morcock AND Rungsun Rerknimitr AND James L.K. Fletcher AND Suwanna Puttamaswin AND Nittaya Phanuphak AND Robin Dewar AND Joseph M. McCune AND Irini Sereti AND Merlin Robb AND Jerome H. Kim AND Timothy W. Schacker AND Peter Hunt AND Jeffrey D. Lifson AND Jintanat Ananworanich AND Jacob D. Estes AND on behalf of the RV254/SEARCH 010 and RV304/SEARCH 013 Study Groups}, journal = {JCI Insight}, publisher = {The American Society for Clinical Investigation}, title = {Impact of early cART in the gut during acute HIV infection}, year = {2016}, month = {7}, volume = {1}, url = {https://insight.jci.org/articles/view/87065}, abstract = {Early after HIV infection there is substantial depletion of CD4+ T cells in the gastrointestinal (GI) tract lamina propria (LP), with associated epithelial barrier damage, leading to microbial translocation and systemic inflammation and immune activation. In this study, we analyzed these early events in the GI tract in a cohort of Thai acute HIV-infected patients and determined the effect of early combination antiretroviral treatment (cART). HIV-uninfected and chronically and acutely HIV-infected patients at different Fiebig stages (I–V) underwent colonic biopsies and then received cART. Immunohistochemistry and quantitative image analysis were performed on cross-sectional and longitudinal colon biopsy specimens (day 0 to week 96) to measure GI tract damage (infiltration of polymorphonuclear cells), inflammation (Mx1, TNF-α), immune activation (Ki-67), and the CD4+ T cell population in the LP. The magnitude of GI tract damage, immune activation, and inflammation was significantly increased, with significantly depleted CD4+ T cells in the LP in all acutely infected groups prior to cART compared with HIV-uninfected control participants. While most patients treated during acute infection resolved GI tract inflammation and immune activation back to baseline levels after 24 weeks of cART, most acutely infected participants did not restore their CD4+ T cells after 96 weeks of cART.}, number = {10}, doi = {10.1172/jci.insight.87065}, url = {https://doi.org/10.1172/jci.insight.87065}, }