Incomplete immune reconstitution in HIV/AIDS patients on antiretroviral therapy: Challenges of immunological non‐responders

The morbidity and mortality of HIV type‐1 (HIV‐1)‐related diseases were dramatically diminished by the grounds of the introduction of potent antiretroviral therapy, which induces persistent suppression of HIV‐1 replication and gradual recovery of CD4+ T‐cell counts. However, ∼10–40% of HIV‐1‐infecte...

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Published in:Journal of leukocyte biology Vol. 107; no. 4; pp. 597 - 612
Main Authors: Yang, Xiaodong, Su, Bin, Zhang, Xin, Liu, Yan, Wu, Hao, Zhang, Tong
Format: Journal Article
Language:English
Published: United States Oxford University Press 01.04.2020
John Wiley and Sons Inc
Subjects:
Acquired immune deficiency syndrome
AIDS
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
CD4 antigen
CD4+ T cells
Chinese Society for Immune Cell Biology Annual Meeting
Drug therapy
HIV
HIV‐1 infection
Human immunodeficiency virus
Immune reconstitution
immunological non‐responders
Immunology
Lymphocytes T
Morbidity
Mortality
Patients
Review
Risk factors
immunological non-responders
immune reconstitution
CD4+ T cells
HIV-1 infection
antiretroviral therapy
ISSN:0741-5400, 1938-3673, 1938-3673
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Summary:The morbidity and mortality of HIV type‐1 (HIV‐1)‐related diseases were dramatically diminished by the grounds of the introduction of potent antiretroviral therapy, which induces persistent suppression of HIV‐1 replication and gradual recovery of CD4+ T‐cell counts. However, ∼10–40% of HIV‐1‐infected individuals fail to achieve normalization of CD4+ T‐cell counts despite persistent virological suppression. These patients are referred to as “inadequate immunological responders,” “immunodiscordant responders,” or “immunological non‐responders (INRs)” who show severe immunological dysfunction. Indeed, INRs are at an increased risk of clinical progression to AIDS and non‐AIDS events and present higher rates of mortality than HIV‐1‐infected individuals with adequate immune reconstitution. To date, the underlying mechanism of incomplete immune reconstitution in HIV‐1‐infected patients has not been fully elucidated. In light of this limitation, it is of substantial practical significance to deeply understand the mechanism of immune reconstitution and design effective individualized treatment strategies. Therefore, in this review, we aim to highlight the mechanism and risk factors of incomplete immune reconstitution and strategies to intervene. Highlights the mechanism and risk factors of incomplete immune reconstitution and strategies to intervene.
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ISSN:0741-5400
1938-3673
1938-3673
DOI:10.1002/JLB.4MR1019-189R