Lymph node expansion of CD4(+) lymphocytes during antiretroviral therapy

The evolution of lymphocyte subsets was analyzed in sequential lymph nodes (LN) biopsies and compared with that in the blood of 25 human immunodeficiency virus type 1 (HIV-l)-infected patients receiving highly active antiretroviral therapy, An average of 3 biopsies were obtained from each patient, with a mean follow-up of 5.6 +/- 0.6 months, A correlation was found between the CD4:CD8 ratio in blood and in LN at baseline but not after greater than or equal to 2 months of therapy, With therapy, there was a significant increase in CD2(+) cells and a much higher CD4(+) cell increase and CD8(+) cell decrease in LNs compared with levels in blood, A subset of patients had increased expression of Ki-67 and a decreased expression of CD8CD38 or CD3HLA-DR. Expanded CD4(+) cells in LNs were mainly CD45RO(+), and changes were concomitant with a decrease in LN virus load, These data demonstrate that CD4 cell reconstitution in HIV-1 infection takes place primarily in secondary lymphoid organs and is not related to a simple redistribution of cells.