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JAC Advance Access originally published online on December 12, 2002
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Journal of Antimicrobial Chemotherapy (2003) 51, 1-4
© 2003 The British Society for Antimicrobial Chemotherapy

Leading Article

Immune reconstitution with antiretroviral therapies in chronic HIV-1 infection

Christoph G. Lange1,* and Michael M. Lederman2

1 Medical Clinic, Research Center Borstel, Medical University of Lübeck, Parkallee 35, 23845 Borstel, Germany; 2 Center for AIDS Research, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland, OH, USA

Keywords: HIV, HAART, immune reconstitution

The first 150 words of the full text of this article appear below.


   Introduction
 
Human immunodeficiency virus 1 (HIV-1) infection is characterized by a progressive decline in both function and number of CD4+ T-lymphocytes secondary to ongoing viral replication. Without intervention, this ultimately leads to the development of the Acquired Immunodeficiency Syndrome (AIDS) that places persons at risk for the acquisition of opportunistic infections and neoplasms.1 In recent years, reconstitution of the immune system of HIV-1-infected patients has been achieved by suppression of HIV-1 replication through antiretroviral therapies (ART), resulting in a dramatic decline in HIV-1-related morbidity and mortality.2 Whereas in the short term, restoration of numbers of circulating CD4+ T-cells seems to largely protect persons from opportunistic infections, it is less clear that functional immune responses can be fully restored particularly in persons with advanced stages of HIV infection. Recent findings from clinical trials and epidemiological studies suggest that the timing of treatment initiation is a major determinant of the capacity of the . . . [Full Text of this Article]


   Restoration of the circulating CD4+ T-cell pool on ART
 

   Restoration of the immune phenotype on ART is often incomplete, particularly if treatment initiation is delayed
 

   Functional immune restoration depends upon timing of treatment initiation
 

   How much immune reconstitution is enough?
 

   Restoration of HIV-1-specific immunity on ART
 

   Conclusions
 

   Acknowledgements
 

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