Biology Reference
In-Depth Information
20
Immune Reconstitution of the CD4 T-Cell
Compartment in HIV Infection
Guislaine Carcelain, Taisheng Li, Marc Renaud, Patrice DebrÂ, and
Brigitte Autran
Laboratoire d'Immunologie Cellulaire et Tissulaire, Unit INSERM 543,
H
Ã
pital Piti
Â
-Salp
Â
tri
Á
re, Paris, France
INTRODUCTION
The infection of the CD4 T-cell compartment by the human imunode®ciency
virus (HIV ) leads to a progressive CD4 cell depletion and to an in¯ammatory
disease of the immune system that eventually causes major cellular immune
defects with severe infectious and tumoral opportunistic events. Flow cytometry
has helped describe a number of cellular alterations apart from the CD4 cell
depletion, quanti®cation of which is the routine marker used to measure pro-
gression of the disease. The introduction of highly active antiretroviral therapy
( HAART ), combining inhibitors of the HIV-1 reverse transcriptase and pro-
tease, has dramatically modi®ed the course of the HIV infection during the past
4 years (Colier et al. 1996; Gulick et al., 1997; Hammer et al. 1997; Katznstein
et al., 1996). Despite some controversies about the extent to which the immune
system can normalize, it is now generally admitted that immune reconstitution
can be obtained and can confer host protection against opportunistic events
(Autran, et al. 1997; Li, et al. 1998; Pakker et al., 1998; Lederman et al., 1998).
The best hallmark of such immune restoration is the progressive reconstitution
of a normal or subnormal CD4 cell compartment and the massive decline in the
mortality and morbidity related to acquired immunode®ciency syndrome (AIDS)
399
