期刊
AIDS
卷 15, 期 -, 页码 S11-S15出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00002030-200102002-00003
关键词
immune restoration; HAART; CD4; lymphocyte proliferation; vaccine
Objectives: To review the current understanding of the details and mechanisms of immune restoration thar follows administration of suppressive antiretroviral therapies to persons with chronic HIV-1 infection. Summary: A first-phase cellular increase often includes increases in multiple circulating lymphocyte populations and is largely attributable to rapid redistribution of cells from lymphoid tissue. A second slower phase is largely comprised of naive cell increases that may reflect cells newly produced in the thymus. Improvement in CD4+ cell function is demonstrable bur functional restoration is incomplete. Immunization can enhance the restoration of CD4+ cell-dependent responses, and the magnitude of restoration is related in part to the degree to which HIV-1 replication and immune activation are controlled. Despite the incomplete nature of immune restoration seen after suppression of HIV-1 replication in chronic infection, clinical benefits of these responses are reflected in decreased HIV-1-related opportunistic infections and mortality. The effects of these therapies on the occurrence of non-Hodgkins lymphoma are less apparent. Conclusions: Suppression of HIV-1 replication results in both laboratory and clinical evidence of immune restoration. Although incomplete, this immune restoration provides 'breathing room' to develop better-tolerated antiviral therapies and therapies designed to enhance immune function. (C) 2001 Lippincott Williams & Wilkins.
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