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1 June 2002

Volume 185, Number 11
The Journal of Infectious Diseases 2002;185:1578–1585
© 2002 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2002/18511-0005$02.00
DOI: 10.1086/340418

Association between Larger Thymic Size and Higher Thymic Output in Human Immunodeficiency Virus–Infected Patients Receiving Highly Active Antiretroviral Therapy

Lilian Kolte,1

Anne‐Mette Dreves,4

Annette K. Ersbøll,5

Charlotte Strandberg,2,a

Dorthe L. Jeppesen,3

Jens O. Nielsen,1

Lars P. Ryder,4

and Susanne D. Nielsen1

Departments of 1Infectious Diseases, 2Radiology, and 3Pediatrics, Hvidovre Hospital, Hvidovre, 4Department of Immunology, Rigshospitalet, and 5Department of Animal Science and Animal Health, Royal Veterinary and Agricultural University, Copenhagen, Denmark

To examine the impact of thymic size on immune recovery in patients with human immunodeficiency virus (HIV) infection, the thymus was visualized, using computed tomographic scans, in 25 HIV‐infected patients who had received highly active antiretroviral therapy (HAART) for 6–18 months and had levels of viremia <500 copies/mL. For comparison, 10 control subjects were included in the study. Total and naive CD4+ cell counts were determined by flow cytometry. To determine thymic output, the number of CD4+ cells containing T cell receptor excision circles (TRECs) was measured. Qualitative immune recovery was evaluated by determination of CD4+ T cell receptor repertoire in 19 of the HIV‐infected patients. Larger thymic size was associated with higher CD4+ cell counts ( ; ) and higher CD4+ TREC frequency ( ; ). Furthermore, patients with abundant thymic tissue seemed to have broader immunologic repertoires, compared with patients with minimal thymic tissue ( ). These findings suggest that thymopoiesis is ongoing in the adult thymus and contributes to immune reconstitution in HIV‐infected patients receiving HAART.

Received 2 October 2001; revised 30 December 2001; electronically published 17 May 2002.

Reprints or correspondence: Dr. S. D. Nielsen, Laboratory for Infectious Diseases, 144, Hvidovre Hospital, 2650 Hvidovre, Denmark.

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  • The study was approved by the local ethics committee (Viderskabsetisk Komité for Københavng og Frederiksberg Kommuner), and informed consent was obtained from all participants.

    Financial support: Ebba Celinders Foundation; Danish Medical Research Council; AIDS Foundation; Hovedstadens Sygehustællesskab.

  • Present affiliation: Department of Radiology, Gentofte Hospital, Hellerup, Denmark.

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