期刊
EXPERT REVIEW OF CLINICAL IMMUNOLOGY
卷 9, 期 11, 页码 1135-1149出版社
TAYLOR & FRANCIS LTD
DOI: 10.1586/1744666X.2013.842897
关键词
apoptosis; CD38; CD57; cell death; immunosenescence; naive T cells; T-cell differentiation
类别
资金
- European Union
- Spanish Ministry of Science and Innovation [PI11/02098]
- Spanish Ministry of Science and Innovation (Red de Investigacion en SIDA RIS) [RETICS12/0014]
- Catalan HIV Vaccine Development Program (HIVACAT)
- 'Gala contra la SIDA' Barcelona
- 'Les Nostres Cancons contra la SIDA' Barcelona
- GlaxoSmithKline
- ViiV
- Merck
- Roche
A relevant fraction of HIV-1-infected individuals (ranging from 15 to 30%) presenting virologically successful highly active antiretroviral therapy fail to recover CD4 T-cell counts. These individuals, called immunodiscordant or immunological nonresponders, are at increased risk of clinical progression and death. Although older age, lower nadir CD4 T-cell count and HCV co-infection are some of clinical predictive factors, immunological mechanisms rely on impaired thymic production and accumulation of apoptosis-prone CD4 T cells. Indeed, immunodiscordant individuals may show increased tissue fibrosis and damage of gut-associated lymphoid tissue that results in higher hyperactivation, inflammation and immunosenescence, altered Treg/Th17 ratio and increased T-cell death. A better knowledge of the final pathogenic mechanism and factors influencing CD4 T-cell recovery will help to select the optimal therapeutic strategies for them.
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