The introduction of cART in the treatment of HIV infection has significantly decreased morbidity and mortality by inducing suppression of viral replication and recovery of CD4+ T-cell counts. How- ever, about 30% of HIV-infected individuals fail to achieve normalization of CD4+ T-cell counts, de- spite antiretroviral therapy and complete suppression of the HIV load: these patients are referred to as "immunological non-responders". Several studies have shown an increased risk of clinical pro- gression to both AIDS and non-AIDS events as well as a higher mortality in these patients. The pathogenetic factors underlying this condition are multiple and none of these alone can exhaustive- ly explain the mechanism of incomplete immune reconstitution. In light of this, the purpose of the present review is to: i) describe in detail the pathogenetic mechanisms that contribute to scarce immune recovery; ii) discuss the higher morbidity and mortality which feature such a condition; iii) take stock of therapeutic strategies used in recent years for these patients.

Failure of CD4+ T-cell recovery upon virally-effective cART : an enduring gap in the understanding of HIV+ immunological non-responders / V. Bono, M. Augello, C. Tincati, G. Marchetti. - In: NEW MICROBIOLOGICA. - ISSN 1121-7138. - 45:3(2022 Jul), pp. 155-172.

Failure of CD4+ T-cell recovery upon virally-effective cART : an enduring gap in the understanding of HIV+ immunological non-responders

V. Bono
Primo
;
M. Augello
Secondo
;
C. Tincati;G. Marchetti
Ultimo
2022

Abstract

The introduction of cART in the treatment of HIV infection has significantly decreased morbidity and mortality by inducing suppression of viral replication and recovery of CD4+ T-cell counts. How- ever, about 30% of HIV-infected individuals fail to achieve normalization of CD4+ T-cell counts, de- spite antiretroviral therapy and complete suppression of the HIV load: these patients are referred to as "immunological non-responders". Several studies have shown an increased risk of clinical pro- gression to both AIDS and non-AIDS events as well as a higher mortality in these patients. The pathogenetic factors underlying this condition are multiple and none of these alone can exhaustive- ly explain the mechanism of incomplete immune reconstitution. In light of this, the purpose of the present review is to: i) describe in detail the pathogenetic mechanisms that contribute to scarce immune recovery; ii) discuss the higher morbidity and mortality which feature such a condition; iii) take stock of therapeutic strategies used in recent years for these patients.
HIV; immunological non-responders; immune reconstitution; CD4+ T-cells
Settore MED/17 - Malattie Infettive
lug-2022
https://newmicrobiologica.org/previous-issues/july2022/#
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/950892
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