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Immunological recovery and antiretroviral therapy in HIV-1 infection

Battegay, Manuel
Nuesch, Reto
Kaufmann, G. R.
Published in The Lancet Infectious Diseases. 2006, vol. 6, no. 5, p. 280-287
Abstract Potent antiretroviral therapy has dramatically improved the prognosis of patients infected with HIV-1. Primary and secondary prophylaxis against Pneumocystis carinii, Mycobacterium avium, cytomegalovirus, and other pathogens can be discontinued safely once CD4 cell counts have increased beyond pathogen-specific thresholds. Approximately one-third of individuals receiving antiretroviral therapy will not reach CD4 cell counts above 500 cells per muL after 5 years despite continuous suppression of plasma HIV-1 RNA. Whether this failure represents a risk factor for the long-term incidence of opportunistic diseases--eg, tuberculosis or malignancies--remains uncertain. We describe the time course of CD4 cell concentrations in patients whose plasma HIV-1 RNA is durably suppressed by antiretroviral therapy, in patients with incomplete suppression of plasma HIV-1 RNA, and during treatment interruptions. In addition, immune reconstitution disease, an inflammatory syndrome associated with immunological recovery occurring days to weeks after the start of antiretroviral therapy, is briefly described.
Keywords Anti-Retroviral Agents/ therapeutic useCD4 Lymphocyte CountCD4-Positive T-Lymphocytes/ immunologyHIV Infections/ drug therapy/ immunologyHIV-1/drug effects/geneticsHumansRNA, Viral/bloodRecovery of FunctionViral Load
PMID: 16631548
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BATTEGAY, Manuel et al. Immunological recovery and antiretroviral therapy in HIV-1 infection. In: The Lancet Infectious Diseases, 2006, vol. 6, n° 5, p. 280-287. doi: 10.1016/S1473-3099(06)70463-7 https://archive-ouverte.unige.ch/unige:7095

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Deposited on : 2010-06-21

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