en
Scientific article
English

Immunological recovery and antiretroviral therapy in HIV-1 infection

Published inLancet. Infectious diseases, vol. 6, no. 5, p. 280-287
Publication date2006
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 use
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes/ immunology
  • HIV Infections/ drug therapy/ immunology
  • HIV-1/drug effects/genetics
  • Humans
  • RNA, Viral/blood
  • Recovery of Function
  • Viral Load
Citation (ISO format)
BATTEGAY, Manuel et al. Immunological recovery and antiretroviral therapy in HIV-1 infection. In: Lancet. Infectious diseases, 2006, vol. 6, n° 5, p. 280–287. doi: 10.1016/S1473-3099(06)70463-7
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ISSN of the journal1473-3099
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