Rifugiati e diritto d’asilo in Europa : tendenze politiche e trasformazione dei diritti

Specific aim of this thesis was to draw a thorough characterization of the immunologic pattern underlying T-cell repopulation in HIV+ patients with "discordant" responses to HAART. Through the comparative analysis of T-cell dymanics and homeostasis, the study aimed at investigating the role of several immunologic mechanisms in the pathogenesis of "discordant" responses. This is a cross-sectional study of 64 HIV+ patients on stable HAART for at least 12 months with comparable clinical epidemiological and HIV-related features: 1. 22 full responders (FRs), HIV-RNA<80 cp/ml, CD4>400/mm3; 27 immunological non responders (INRs), HIV-RNA<80 cp/ml, CD4<200/mm3; 15 virological non responders (VNRs) HIV-RNA>10000 cp/ml, CD4>400/mm3. The results of this study allowed to identify different immune reconstitution patterns featuring the cohorts of patients studied. In particular, even though INRs presented increased plasma levels of IL-7 - main regulator of T-cell homeostasis - with conserved IL-7 receptor proportions and augmented neothymopoiesis, they still displayed augmented levels of T-cell activation and proliferation with a consequent rise in CD4+ apoptosis, which ultimately resulted in the CD4+ loss. Specific hallmark of VNRs was increased neothymopoiesis, associated to limited T-cell activation and apoptosis, thus guaranteeing the maintenance of a normal CD4+ T-cell pool.