The absence of CD4+ T cell count recovery despite receipt of virologically suppressive highly active antiretroviral therapy: clinical risk, immunological gaps, and therapeutic options
Up to 30% of human immunodeficiency virus (HIV)-infected patients who are receiving long-term highly active antiretroviral therapy do not exhibit a marked increase in the CD4(+) T cell count, despite achieving complete suppression of the HIV load. These patients are referred to as "immunologica...
Uloženo v:
| Vydáno v: | Clinical infectious diseases Ročník 48; číslo 3; s. 328 |
|---|---|
| Hlavní autoři: | , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
01.02.2009
|
| Témata: | |
| ISSN: | 1537-6591, 1537-6591 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | Up to 30% of human immunodeficiency virus (HIV)-infected patients who are receiving long-term highly active antiretroviral therapy do not exhibit a marked increase in the CD4(+) T cell count, despite achieving complete suppression of the HIV load. These patients are referred to as "immunological nonresponders." When treating immunological nonresponders, the practicing clinician has several questions, including questions about the clinical risk associated with persistent immunodeficiency and about possible approaches to treatment that would provide clinical and immunological benefits. However, tentative answers to these questions require investigations of the mechanisms that underlie the lack of immune recovery, because only the deepest comprehension of the immunological gaps underlying functional defects will allow administration of highly targeted and efficacious treatment strategies. The aim of our review is to provide a thorough assessment of the clinical implications of a lack of increase in the CD4(+) T cell count in immunological nonresponders, to examine the immunological gaps limiting recovery of the CD4(+) T cell count, and to note possible therapeutic avenues, which may offer clinicians guidance regarding how to most efficaciously treat these critical patients. |
|---|---|
| AbstractList | Up to 30% of human immunodeficiency virus (HIV)-infected patients who are receiving long-term highly active antiretroviral therapy do not exhibit a marked increase in the CD4(+) T cell count, despite achieving complete suppression of the HIV load. These patients are referred to as "immunological nonresponders." When treating immunological nonresponders, the practicing clinician has several questions, including questions about the clinical risk associated with persistent immunodeficiency and about possible approaches to treatment that would provide clinical and immunological benefits. However, tentative answers to these questions require investigations of the mechanisms that underlie the lack of immune recovery, because only the deepest comprehension of the immunological gaps underlying functional defects will allow administration of highly targeted and efficacious treatment strategies. The aim of our review is to provide a thorough assessment of the clinical implications of a lack of increase in the CD4(+) T cell count in immunological nonresponders, to examine the immunological gaps limiting recovery of the CD4(+) T cell count, and to note possible therapeutic avenues, which may offer clinicians guidance regarding how to most efficaciously treat these critical patients. Up to 30% of human immunodeficiency virus (HIV)-infected patients who are receiving long-term highly active antiretroviral therapy do not exhibit a marked increase in the CD4(+) T cell count, despite achieving complete suppression of the HIV load. These patients are referred to as "immunological nonresponders." When treating immunological nonresponders, the practicing clinician has several questions, including questions about the clinical risk associated with persistent immunodeficiency and about possible approaches to treatment that would provide clinical and immunological benefits. However, tentative answers to these questions require investigations of the mechanisms that underlie the lack of immune recovery, because only the deepest comprehension of the immunological gaps underlying functional defects will allow administration of highly targeted and efficacious treatment strategies. The aim of our review is to provide a thorough assessment of the clinical implications of a lack of increase in the CD4(+) T cell count in immunological nonresponders, to examine the immunological gaps limiting recovery of the CD4(+) T cell count, and to note possible therapeutic avenues, which may offer clinicians guidance regarding how to most efficaciously treat these critical patients.Up to 30% of human immunodeficiency virus (HIV)-infected patients who are receiving long-term highly active antiretroviral therapy do not exhibit a marked increase in the CD4(+) T cell count, despite achieving complete suppression of the HIV load. These patients are referred to as "immunological nonresponders." When treating immunological nonresponders, the practicing clinician has several questions, including questions about the clinical risk associated with persistent immunodeficiency and about possible approaches to treatment that would provide clinical and immunological benefits. However, tentative answers to these questions require investigations of the mechanisms that underlie the lack of immune recovery, because only the deepest comprehension of the immunological gaps underlying functional defects will allow administration of highly targeted and efficacious treatment strategies. The aim of our review is to provide a thorough assessment of the clinical implications of a lack of increase in the CD4(+) T cell count in immunological nonresponders, to examine the immunological gaps limiting recovery of the CD4(+) T cell count, and to note possible therapeutic avenues, which may offer clinicians guidance regarding how to most efficaciously treat these critical patients. |
| Author | Bellistrì, Giusi Maria Tincati, Camilla Gazzola, Lidia Monforte, Antonella d'Arminio Marchetti, Giulia |
| Author_xml | – sequence: 1 givenname: Lidia surname: Gazzola fullname: Gazzola, Lidia organization: Department of Medicine, Surgery, and Dentistry, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy – sequence: 2 givenname: Camilla surname: Tincati fullname: Tincati, Camilla – sequence: 3 givenname: Giusi Maria surname: Bellistrì fullname: Bellistrì, Giusi Maria – sequence: 4 givenname: Antonella d'Arminio surname: Monforte fullname: Monforte, Antonella d'Arminio – sequence: 5 givenname: Giulia surname: Marchetti fullname: Marchetti, Giulia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/19123868$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkM1OwzAQhC1URH-AR0A-caGFOImdhBsqv1IlLuVcbZ1Na0hsYzuV-mS8HoloJU47O_pmDjMmA200EnLJolsW5eKOFzzn7ISMGE-ymeAFG_zTQzL2_jOKGMsjfkaGrGBxkot8RH6WW6Sw9qglUlPR-WN6Q5dUYl1TaVodqENpduj2tERvVcDeQGVDT--UM7XZKAl1vae-tdah92qHdKs2284CGfoPdFAOgzNdAGoatujA7u-prJXuw9Qp_zWlqmlafSykG7B-2kXLA49tUJIaG5TR_pycVlB7vDjcCfl4flrOX2eL95e3-cNiJhMuwiypMgapLIoqYQw7mWZpATyOgUNcijLjwIQoY8wg7_6ilHHZjVNAlgiOgPGEXP_1Wme-W_Rh1SjfrwMaTetXQuQR47nowKsD2K4bLFfWqQbcfnWcOv4Fz9WExA |
| CitedBy_id | crossref_primary_10_1186_s12967_015_0601_2 crossref_primary_10_1002_sim_3725 crossref_primary_10_1186_1471_2334_10_318 crossref_primary_10_1371_journal_pone_0219201 crossref_primary_10_3389_fimmu_2022_1066036 crossref_primary_10_1089_aid_2010_0086 crossref_primary_10_1093_infdis_jiz185 crossref_primary_10_1517_14712598_2013_779251 crossref_primary_10_1186_s13104_016_1991_9 crossref_primary_10_1186_1745_6215_15_390 crossref_primary_10_1016_j_atherosclerosis_2014_08_054 crossref_primary_10_1586_1744666X_2013_842897 crossref_primary_10_1371_journal_pone_0217742 crossref_primary_10_3389_fimmu_2019_00233 crossref_primary_10_3389_fimmu_2022_869286 crossref_primary_10_1186_1471_2334_11_343 crossref_primary_10_1517_17425255_2014_854330 crossref_primary_10_3389_fmicb_2022_1004960 crossref_primary_10_1155_2012_515962 crossref_primary_10_2147_HIV_S483094 crossref_primary_10_4102_sajhivmed_v20i1_1013 crossref_primary_10_1089_aid_2009_0263 crossref_primary_10_1177_15598276221078222 crossref_primary_10_1155_2012_935425 crossref_primary_10_1089_aid_2013_0097 crossref_primary_10_3389_fmolb_2021_809085 crossref_primary_10_1186_s12977_016_0261_1 crossref_primary_10_1186_1471_2172_14_26 crossref_primary_10_1089_aid_2012_0192 crossref_primary_10_1128_JVI_00571_15 crossref_primary_10_1186_1471_2334_12_14 crossref_primary_10_1186_s12865_019_0317_9 crossref_primary_10_3389_fimmu_2021_796898 crossref_primary_10_1186_1471_2334_11_43 crossref_primary_10_1186_s12979_019_0166_7 crossref_primary_10_1586_17476348_2016_1157474 crossref_primary_10_1186_1471_2172_15_2 |
| ContentType | Journal Article |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1086/595851 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1537-6591 |
| ExternalDocumentID | 19123868 |
| Genre | Research Support, Non-U.S. Gov't Journal Article Review |
| GroupedDBID | --- ..I .2P .I3 .ZR 08P 0R~ 1TH 29B 2AX 2WC 36B 4.4 48X 53G 5GY 5RE 5VS 5WD 6J9 AABZA AACGO AACZT AAJKP AAJQQ AAMVS AANCE AAOGV AAPQZ AAPXW AAQQT AARHZ AAUAY AAUQX AAVAP AAYOK ABBHK ABDFA ABEJV ABEUO ABGNP ABIXL ABJNI ABLJU ABNGD ABNHQ ABOCM ABPLY ABPQP ABPTD ABQLI ABQNK ABTLG ABVGC ABWST ABXSQ ABXVV ACGFO ACGFS ACHIC ACPRK ACUFI ACUKT ACUTJ ACUTO ACYHN ADBBV ADGZP ADHKW ADHZD ADIPN ADNBA ADQBN ADQXQ ADRTK ADULT ADVEK ADYVW ADZXQ AEGPL AEGXH AEJOX AEKSI AEMDU AEMQT AENEX AENZO AEPUE AETBJ AEUPB AEWNT AEXZC AFFNX AFFZL AFIYH AFOFC AFRAH AFXAL AGINJ AGQXC AGSYK AGUTN AHMBA AHMMS AHXPO AIAGR AJEEA AJNCP ALMA_UNASSIGNED_HOLDINGS ALUQC ALXQX APIBT APWMN AQKUS AQVQM ASPBG ATGXG AVWKF AXUDD AZFZN BAWUL BAYMD BCRHZ BEYMZ BHONS BTRTY BVRKM C1A C45 CDBKE CGR CS3 CUY CVF CZ4 DAKXR DCCCD DIK DILTD DU5 D~K E3Z EBS ECM EE~ EIF EJD EMOBN ENERS F5P F9B FECEO FEDTE FLUFQ FOEOM FOTVD FQBLK GAUVT GJXCC H13 H5~ HAR HTVGU HVGLF HW0 HZ~ IOX IPSME J21 JAAYA JBMMH JENOY JHFFW JKQEH JLS JLXEF JPM JSG JST JXSIZ KAQDR KBUDW KOP KSI KSN L7B M49 MHKGH MJL ML0 N4W N9A NGC NOMLY NOYVH NPM NU- NVLIB O0~ O9- OAUYM OAWHX OCZFY ODMLO ODZKP OJQWA OJZSN OK1 OPAEJ OVD OWPYF P2P P6G PAFKI PB- PEELM PQQKQ Q1. Q5Y QBD RD5 ROX ROZ RUSNO RW1 RXO SA0 SJN TCURE TEORI TJX TMA TR2 W8F X7H YAYTL YKOAZ YXANX ~91 ~S- 7X8 AGQPQ AJBYB |
| ID | FETCH-LOGICAL-c356t-3f71a4c99f311e1a44749a522a5a2d6d75a166d2e7a82d69dc2d1919a7365eae2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 183 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000262291200010&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1537-6591 |
| IngestDate | Thu Oct 02 09:49:24 EDT 2025 Thu Apr 03 07:04:40 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 3 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c356t-3f71a4c99f311e1a44749a522a5a2d6d75a166d2e7a82d69dc2d1919a7365eae2 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
| PMID | 19123868 |
| PQID | 66801586 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_66801586 pubmed_primary_19123868 |
| PublicationCentury | 2000 |
| PublicationDate | 2009-02-01 |
| PublicationDateYYYYMMDD | 2009-02-01 |
| PublicationDate_xml | – month: 02 year: 2009 text: 2009-02-01 day: 01 |
| PublicationDecade | 2000 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Clinical infectious diseases |
| PublicationTitleAlternate | Clin Infect Dis |
| PublicationYear | 2009 |
| SSID | ssj0011805 |
| Score | 2.3969836 |
| SecondaryResourceType | review_article |
| Snippet | Up to 30% of human immunodeficiency virus (HIV)-infected patients who are receiving long-term highly active antiretroviral therapy do not exhibit a marked... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 328 |
| SubjectTerms | Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count CD4-Positive T-Lymphocytes - immunology HIV Infections - drug therapy HIV Infections - immunology Humans Treatment Outcome Viral Load |
| Title | The absence of CD4+ T cell count recovery despite receipt of virologically suppressive highly active antiretroviral therapy: clinical risk, immunological gaps, and therapeutic options |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/19123868 https://www.proquest.com/docview/66801586 |
| Volume | 48 |
| WOSCitedRecordID | wos000262291200010&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1La9wwEBZpE0ovzaOPpHnNIbdE1LZeVimUkgc9NEsOCezNyJJcFsp6u3YC-8vy9zrjB8ml9NCDjS0sW3hGn0aa-TSMnahSxujLiufBSS5j5TlOI0qujPVJUpYiVN2W-T_MZJJPp_ZmjX0ZuTAUVjliYgfUofa0Rv5Ja8RSleuvi9-cckaRb3VIoPGCrQs0ZCigy0yffAhp3gUwYpc2XCubPssspCx5w_5uVHaDy9Xm_zVri70ZjEr41mvBNluL8x326npwm79lj6gM4MqGejHUFZxfyFO4BVq0hy5ZBNC8GJV6BYFc722kgohwQk8TE25AyF8raO4XfezsQwTa6xiLXIeZgDJC_GxpjWKJremZXavPMJIvgcLYz2BGjJTxhfDTLZozrBrgGRMM6j7U5h27u7q8Pf_Oh4wN3AulWy4qkzrpra1Emka8lEZahyaeUy4LOhjlUq1DFo3L8d4GnwWcMFpnhFbRxew9ezmv53GXgVeZizIRpQ5R4mETJ8os99aJiuj7e-x4FEiBPYL-mJvH-r4pRpHssQ-9TItFv3FHgZ9CC0XnH_9Zd5-97t1GFLdywNYrxIJ4yDb8QztrlkedouF5cnP9B-Gv47o |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+absence+of+CD4%2B+T+cell+count+recovery+despite+receipt+of+virologically+suppressive+highly+active+antiretroviral+therapy%3A+clinical+risk%2C+immunological+gaps%2C+and+therapeutic+options&rft.jtitle=Clinical+infectious+diseases&rft.au=Gazzola%2C+Lidia&rft.au=Tincati%2C+Camilla&rft.au=Bellistr%C3%AC%2C+Giusi+Maria&rft.au=Monforte%2C+Antonella+d%27Arminio&rft.date=2009-02-01&rft.eissn=1537-6591&rft.volume=48&rft.issue=3&rft.spage=328&rft_id=info:doi/10.1086%2F595851&rft_id=info%3Apmid%2F19123868&rft_id=info%3Apmid%2F19123868&rft.externalDocID=19123868 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1537-6591&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1537-6591&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1537-6591&client=summon |