4.3 Review

Immunodiscordant responses to HAART - mechanisms and consequences

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

资金

  1. European Union
  2. Spanish Ministry of Science and Innovation [PI11/02098]
  3. Spanish Ministry of Science and Innovation (Red de Investigacion en SIDA RIS) [RETICS12/0014]
  4. Catalan HIV Vaccine Development Program (HIVACAT)
  5. 'Gala contra la SIDA' Barcelona
  6. 'Les Nostres Cancons contra la SIDA' Barcelona
  7. GlaxoSmithKline
  8. ViiV
  9. Merck
  10. Roche

向作者/读者索取更多资源

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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