Immunomodulants in HIV Infection

The current antiretroviral therapy has improved the clinical outcome of HIV-infected patients. However, drug toxicity, the emergence of drug-resistant HIV variants and the incomplete reconstitution of immune response underline the need for additional therapeutic approaches. Adjuvant therapies with immunomodulants, such as cytokines, immunosuppressants, or compounds selectively targeting HIV-specific immunity, are being intensively investigated as potential supplements to antiretroviral therapy. Although much data have been generated, there has been little evidence of the clinical efficacy of these strategies to date, and the need for new effective and reproducible immune surrogate markers able to identify the actual improvement derived from an immunotherapeutic strategy is becoming a priority. The demonstration of a possible role in inducing a better control of HIV infection and the identification of settings in which these therapies should be more effective will be essential if immunomodulants are to be included in the therapeutic armamentarium against HIV.