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高效抗病毒治疗促使艾滋病患者免疫功能重建
The characteristics of AIDS is that HIV infection induces CD4 + T cell defects that includes a quantitave CD4 + T cells depletion and a loss of T helper cells function leading to a progressive immune deficiency. Early report indicated that this immune deficiency was irreversible, even with the antiretroviral therapies. More recently, however, clinical benifits of hightly active antiretroviral therapies (HAART) are increasingly evidenced by resolving opportunistic infections and malignancies, as well as declining hospitalization and mortality rates. This suggests that potent and sustained suppression of viral replication, at least to some extent, is associated with reconstitution of the immune system even in adult patients treated at advanced stages of the disease. Such immune reconstitution which was demonstrated firstly by a French reseach group includes (the group leader is Pr Brigitte Autran)(1) a rapid rise in CD4 + and CD8+ T cells followed by a slower CD4 + T cell increase; (2) a rapid rise in memory CD4 + T cells during the first three months of treatment by late increase in naive T cells coexpressing CD45RA and CD62L molecules after 3 months of efficient antiviral treatment;(3) a significant reduction of CD4 and CD8 activation markers in parallel to plasma virus load reduction;(4) a restoration in CD4 + T cell reactivity to recall antigens. These observations open new perspectives for the understanding of CD4 + T cells deficiency and therapeutic strategies of HIV infection. In the present review we will address some of the questions raised by immune restoration with HAART when administered at advanced stages of the disease.
