Skip to main content
SpringerLink
Log in

Immunological Responses to Antiretroviral Therapy

Encyclopedia of AIDS

  • 398 Accesses

Definition

Maintenance or restoration of immune function is a major goal of treating HIV infection with antiretroviral therapy (ART). Patients who achieve a normal CD4+ T cell count of >500/μL are unlikely to experience opportunistic infections and can expect a near-normal life expectancy, whereas patients whose CD4+ T cell count does not increase above 200/μL have substantially increased long-term mortality. Up to 36 % of patients receiving ART never achieve a normal CD4+ T cell count and immune dysfunction may persist in those that do. Furthermore, immune reconstitution may, paradoxically, result in patients being more susceptible to some immunological disorders. Here, mechanisms of immune reconstitution and the causes, consequences, and management of persistent immune dysfunction and immune reconstitution disorders will be discussed.

Reconstitution of the Immune System Following Suppression of HIV Replication by ART

Depletion of blood CD4+ T cells is the most characteristic immune...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Barber DL, et al. Immune reconstitution inflammatory syndrome: the trouble with immunity when you had none. Nat Rev Microbiol. 2012;10:150–6.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Boulware DR, et al. Clinical features and serum biomarkers in HIV immune reconstitution inflammatory syndrome after cryptococcal meningitis: a prospective cohort study. PLoS Med. 2010;7:e1000384.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brenchley JM, et al. Microbial translocation is a cause of systemic immune activation in chronic HIV infection. Nat Med. 2006;12:1365–71.

    Article  CAS  PubMed  Google Scholar 

  • Cha L, et al. Interferon-alpha, immune activation and immune dysfunction in treated HIV infection. Clin Trans Immunol. 2014;3:e10.

    Article  Google Scholar 

  • Chang CC, et al. HIV and co-infections. Immunol Rev. 2013;254:114–42.

    Article  PubMed Central  PubMed  Google Scholar 

  • Crum NF, et al. Graves disease: an increasingly recognized immune reconstitution syndrome. AIDS. 2006;20:466–9.

    Article  PubMed  Google Scholar 

  • Estes JD. Pathobiology of HIV/SIV-associated changes in secondary lymphoid tissues. Immunol Rev. 2013;254:65–77.

    Article  PubMed  Google Scholar 

  • Foulon G, et al. Sarcoidosis in HIV-infected patients in the era of highly active antiretroviral therapy. Clin Infect Dis. 2004;38:418–25.

    Article  PubMed  Google Scholar 

  • Franco JM, et al. T-cell repopulation and thymic volume in HIV-1-infected adult patients after highly active antiretroviral therapy. Blood. 2002;99:3702–6.

    Article  CAS  PubMed  Google Scholar 

  • Kelley CF, et al. Incomplete peripheral CD4+ cell count restoration in HIV-infected patients receiving long-term antiretroviral treatment. Clin Infect Dis. 2009;48:787–94.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lederman MM, et al. Residual immune dysregulation syndrome in treated HIV infection. Adv Immunol. 2013;119:51–83.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Meintjes G, et al. Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings. Lancet Infect Dis. 2008;8:516–23.

    Article  PubMed Central  PubMed  Google Scholar 

  • Moir S, et al. B cells in HIV infection and disease. Nat Rev Immunol. 2009;9:235–45.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Rajasuriar R, et al. Persistent immune activation in chronic HIV infection: do any interventions work? AIDS. 2013;27:1199–208.

    Article  PubMed  Google Scholar 

  • Yanik EL, et al. Incidence and timing of cancer in HIV-infected individuals following initiation of combination antiretroviral therapy. Clin Infect Dis. 2013;57:756–64.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Pathology and Laboratory Medicine, University of Western Australia, Medical Research Foundation Building, Level 2, Rear 50 Murray Street, Perth, WA, 6000, Australia

    Martyn A French

  2. Department of Clinical Immunology, Royal Perth Hospital and PathWest Laboratory Medicine, Perth, Australia

    Martyn A French

Authors
  1. Martyn A French
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martyn A French .

Editor information

Editors and Affiliations

  1. Dept. Cell & Molecular Biology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA

    Thomas J. Hope

  2. Office of Graduate and Postdoctoral Studies, University of Miami, Miller School of Medicine, Miami, Florida, USA

    Mario Stevenson

  3. University of California, San Diego Dept. Pathology, La Jolla, California, USA

    Douglas Richman

Rights and permissions

Reprints and permissions

Copyright information

© 2014 © Crown

About this entry

Cite this entry

French, M.A. (2014). Immunological Responses to Antiretroviral Therapy. In: Hope, T., Stevenson, M., Richman, D. (eds) Encyclopedia of AIDS. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9610-6_301-1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-9610-6_301-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-9610-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Chapter history

  1. Latest

    HIV-2: Lessons from the Dakar Cohort
    Published:
    01 October 2014

    DOI: https://doi.org/10.1007/978-1-4614-9610-6_45-1

  2. Original

    Immunological Responses to Antiretroviral Therapy
    Published:
    30 September 2014

    DOI: https://doi.org/10.1007/978-1-4614-9610-6_301-1

Search

Navigation