PDF(Pubmed)
Abstract：
Combination antiretroviral therapy has demonstrated proved effectiveness in suppressing viral replication and significantly recovering CD4+ T cell count in HIV type-1 (HIV-1)-infected patients, contributing to a dramatic reduction in AIDS morbidity and mortality. However, the factors affecting immune reconstitution are extremely complex. Demographic factors, co-infection, baseline CD4 cell level, abnormal immune activation, and cytokine dysregulation may all affect immune reconstitution. According to report, 10-40% of HIV-1-infected patients fail to restore the normalization of CD4+ T cell count and function. They are referred to as immunological non-responders (INRs) who fail to achieve complete immune reconstitution and have a higher mortality rate and higher risk of developing other non-AIDS diseases compared with those who achieve complete immune reconstitution. Heretofore, the mechanisms underlying incomplete immune reconstitution in HIV remain elusive, and INRs are not effectively treated or mitigated. This review discusses the recent progress of mechanisms and factors responsible for incomplete immune reconstitution in AIDS and summarizes the corresponding therapeutic strategies according to different mechanisms to improve the individual therapy.
摘要：
联合抗逆转录病毒治疗已证明在抑制病毒复制和显著恢复HIV-1（HIV-1）感染患者的CD4+T细胞计数方面有效。有助于大幅降低艾滋病的发病率和死亡率。然而,影响免疫重建的因素非常复杂。人口因素,合并感染,基线CD4细胞水平，异常免疫激活，和细胞因子失调都可能影响免疫重建。据报道,10-40％的HIV-1感染患者未能恢复CD4T细胞计数和功能的正常化。它们被称为免疫非应答者(INR),其不能实现完全免疫重建,并且与实现完全免疫重建的那些相比具有更高的死亡率和更高的发展其他非AIDS疾病的风险。在此之前，HIV中不完全免疫重建的潜在机制仍然难以捉摸，和INR没有得到有效治疗或缓解。本文综述了艾滋病免疫重建不完全的机制和因素的最新进展，并根据不同的机制总结了相应的治疗策略，以改善个体化治疗。
