The impact of highly active antiretroviral therapy on HIV-specific immune function

被引:12
作者
Saag, MS [1 ]
机构
[1] Univ Alabama, Dept Med, AIDS Clin Trials Unit, Birmingham, AL 35294 USA
关键词
HAART; undetectable plasma HIV RNA; CD4 T lymphocyte; CD8+T lymphocyte; half-life; immune reconstitution; naive cell; memory cell;
D O I
10.1097/00002030-200102002-00002
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Highly active antiretroviral therapy (HAART) can suppress HIV type 1 plasma viremia to undetectable levels for up to 3 years or more. When the therapy is discontinued, viral rebound occurs in a majority of patients, indicating that HAART is unable to completely eradicate the virus. Initial calculations of the half-lives of the infected cells (estimated to be 14-21 days) suggested that only 3 years continuous HAART therapy would be necessary to achieve complete eradication; however, several studies have determined that the half-lives of chronically infected cells are in the order of 6-44 months. New estimates indicate that it may take as long as GO years to eradicate the virus. Thus, there has been movement toward combining HAART with various means of augmenting and/or reconstituting the host's immune system, especially HIV-1-specific immune responses. The long-term goal is to discontinue HAART and permit the reconstituted immune system to contain whatever small amounts of the virus remain. (C) 2001 Lippincott Williams & Wilkins.
引用
收藏
页码:S4 / S10
页数:7
相关论文
共 48 条
[1]   Positive effects of combined antiretroviral therapy on CD4(+) T cell homeostasis and function in advanced HIV disease [J].
Autran, B ;
Carcelain, G ;
Li, TS ;
Blanc, C ;
Mathez, D ;
Tubiana, R ;
Katlama, C ;
Debre, P ;
Leibowitch, J .
SCIENCE, 1997, 277 (5322) :112-116
[2]   In vivo migration and function of transferred HIV-1-specific cytotoxic T cells [J].
Brodie, SJ ;
Lewinsohn, DA ;
Patterson, BK ;
Jiyamapa, D ;
Krieger, J ;
Corey, L ;
Greenberg, PD ;
Riddell, SR .
NATURE MEDICINE, 1999, 5 (01) :34-41
[3]   Initial increase in blood CD4+ lymphocytes after HIV antiretroviral therapy reflects redistribution from lymphoid tissues [J].
Bucy, RP ;
Hockett, RD ;
Derdeyn, CA ;
Saag, MS ;
Squires, K ;
Sillers, M ;
Mitsuyasu, RT ;
Kilby, JM .
JOURNAL OF CLINICAL INVESTIGATION, 1999, 103 (10) :1391-1398
[4]  
BUCY RP, 1998, 5 C RETR OPP INF 5 C
[5]  
Calarota SA, 1999, J IMMUNOL, V163, P2330
[6]   Quantification of latent tissue reservoirs and total body viral load in HIV-1 Infection [J].
Chun, TW ;
Carruth, L ;
Finzi, D ;
Shen, XF ;
DiGiuseppe, JA ;
Taylor, H ;
Hermankova, M ;
Chadwick, K ;
Margolick, J ;
Quinn, TC ;
Kuo, YH ;
Brookmeyer, R ;
Zeiger, MA ;
BarditchCrovo, P ;
Siliciano, RF .
NATURE, 1997, 387 (6629) :183-188
[7]   Effect of interleukin-2 on the pool of latently infected, resting CD4+ T cells in HIV-1-infected patients receiving highly active anti-retroviral therapy [J].
Chun, TW ;
Engel, D ;
Mizell, SB ;
Hallahan, CW ;
Fischette, M ;
Park, S ;
Davey, RT ;
Dybul, M ;
Kovacs, JA ;
Metcalf, JA ;
Mican, JM ;
Berrey, MM ;
Corey, L ;
Lane, HC ;
Fauci, AS .
NATURE MEDICINE, 1999, 5 (06) :651-655
[8]   IDENTIFICATION OF RANTES, MIP-1-ALPHA, AND MIP-1-BETA AS THE MAJOR HIV-SUPPRESSIVE FACTORS PRODUCED BY CD8(+) T-CELLS [J].
COCCHI, F ;
DEVICO, AL ;
GARZINODEMO, A ;
ARYA, SK ;
GALLO, RC ;
LUSSO, P .
SCIENCE, 1995, 270 (5243) :1811-1815
[9]   Latent reservoirs of HIV infection: Flushing with IL-2? [J].
Cooper, DA ;
Emery, S .
NATURE MEDICINE, 1999, 5 (06) :611-612
[10]   Latent infection of CD4+ T cells provides a mechanism for lifelong persistence of HIV-1, even in patients on effective combination therapy [J].
Finzi, D ;
Blankson, J ;
Siliciano, JD ;
Margolick, JB ;
Chadwick, K ;
Pierson, T ;
Smith, K ;
Lisziewicz, J ;
Lori, F ;
Flexner, C ;
Quinn, TC ;
Chaisson, RE ;
Rosenberg, E ;
Walker, B ;
Gange, S ;
Gallant, J ;
Siliciano, RF .
NATURE MEDICINE, 1999, 5 (05) :512-517