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During HIV infection the severe depletion of intestinal CD4  +   T-cells is associated with microbial translocation, systemic immune activation, and disease progression. This study examined intestinal and peripheral CD4  +   T-cell subsets reconstitution under combined antiretroviral therapy (cART), and systemic immune activation markers.    Methods  This longitudinal single-arm pilot study evaluates CD4 +  T cells, including Th1 and Th17, in gut and blood and soluble markers for inflammation in HIV-infected individuals before (M0) and after eight (M8) months of cART. From January 2010 to December 2011, 10 HIV-1 naïve patients were screened and 9 enrolled. Blood and gut CD4 +  T-cells subsets and cellular immune activation were determined by flow-cytometry and plasma soluble CD14 by ELISA. CD4 +  Th17 cells were detected in gut biopsies by immunohistochemistry. Microbial translocation was measured by limulus-amebocyte-lysate assay to detect bacterial lipopolysaccharide (LPS) and PCR Real Time to detect plasma bacterial 16S rDNA.    Results  Eight months of cART increased intestinal CD4  +   and Th17 cells and reduced levels of T-cell activation and proliferation. The magnitude of intestinal CD4  +   T-cell reconstitution correlated with the reduction of plasma LPS. Importantly, the magnitude of Th17 cells reconstitution correlated directly with blood CD4  +   T-cell recovery.    Conclusion  Short-term antiretroviral therapy resulted in a significant increase in the levels of total and Th17 CD4  +   T-cells in the gut mucosa and in decline of T-cell activation. The observation that pre-treatment levels of CD4  +   and of CD8  +   T-cell activation are predictors of the magnitude of Th17 cell reconstitution following cART provides further rationale for an early initiation of cART in HIV-infected individuals.    Trial Registration  ClinicalTrials.gov  NCT02097381

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Reconstitution of Intestinal CD4 and Th17 T Cells in Antiretroviral Therapy Suppressed HIV-Infected Subjects: Implication for Residual Immune Activation from the Results of a Clinical Trial