Ferrando-Martinez, SaraDe Pablo-Bernal, Rebeca SDe Luna-Romero, MartaDe Ory, Santiago JGenebat, MiguelPacheco, Yolanda MParras, Francisco JMontero, MartaBlanco, Jose RamónGutierrez, FelixSantos, JesusVidal, FranciscoKoup, Richard AMuñoz-Fernández, María ÁngelesLeal, ManuelRuiz-Mateos, Ezequiel2023-01-252023-01-252017http://hdl.handle.net/10668/10835Thymic function has been mainly analyzed with surrogate peripheral markers affected by peripheral T-cell expansion, making it difficult to assess the role of thymic failure in human immunodeficiency virus (HIV) disease progression. The assay of signal-joint/DβJβ T-cell rearrangement excision circles (sj/β-TREC ratio) overcomes this limitation but has only been assayed in small cohorts. Thus, the aim of this study was to determine the role of thymic function, measured by the sj/β-TREC ratio, on CD4 T-cell maintenance in prospective HIV cohorts that include patients with a wide age range and different immunological phenotypes. Seven hundred seventy-four patients including typical progressors, long-term nonprogressors (LTNPs), and vertically HIV-infected subjects were analyzed. Thymic function was quantified in peripheral blood samples using the sj/β-TREC ratio. Associations between thymic function and CD4 T-cell dynamics and combination antiretroviral therapy (cART) onset were analyzed using linear, logistic, and Cox proportional hazard models. Thymic function failure (sj/β-TREC ratio This work establishes the relevance of thymic function, measured by sj/β-TREC ratio, in HIV disease progression by analyzing a large number of patients in 3 cohorts with different HIV disease progression phenotypes. These results support and help to understand the mechanisms underlying the rationale of early cART onset.enHIV disease progressionLTNPsj/β-TREC ratiothymic functionvertical infectionAdolescentAdultAgedAnti-Retroviral AgentsBiomarkersCD4 Lymphocyte CountCD4-Positive T-LymphocytesChildChild, PreschoolDisease ProgressionFemaleHIV InfectionsHumansInfantMaleMiddle AgedProspective StudiesThymus GlandYoung Adultresearch article28158588open access10.1093/cid/cix0951537-6591PMC6248450https://academic.oup.com/cid/article-pdf/64/9/1191/17353010/cix095.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248450/pdf