Objectives: We evaluated virologic and immunologic responses to antiretrovi
ral therapy in gut-associated lymphoid tissue (GALT) compared with those fo
und in peripheral blood.
Methods: Eight HIV-1-infected individuals were treated with three reverse t
ranscriptase inhibitors and one protease inhibitor. Endoscopic biopsies wer
e performed at baseline, and at months 1, 2, and 6. We measured the level o
f cell-associated multiply spliced and unspliced HIV-1 mRNA in GALT and in
peripheral blood mononuclear cells. Immunologic responses were assessed by
Results: Levels of multiply spliced HIV-1 mRNA declined in parallel fashion
both in peripheral blood and GALT. After 6 months of therapy, unspliced HI
V-1 mRNA in the GALT was below assay detection although it persisted in per
ipheral blood mononuclear cells in 4 study subjects. Although the percentag
e of CD4(+) lymphocytes increased significantly in peripheral blood, only m
odest increases occurred in GALT. The percentage of activated CD8(+) T cell
s decreased significantly in peripheral blood whereas only modest reduction
s occurred in GALT.
Conclusions: Antiretroviral therapy effectively suppressed HIV-1 replicatio
n in GALT. The percentage of CD4(+) T cells in peripheral blood uniformly i
ncreased in all study subjects, whereas it was more variable in the GALT.