Immunity to Human Immunodeficiency Virus (HIV) Infection
1HIV/AIDS Unit, Institute of Infectious and Tropical Diseases, School of Medicine, University of Brescia, Spedali Civili Square 1, 25123 Brescia, Italy
2School of Medicine, Emory University, Atlanta, GA 30322, USA
3Division of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Pergolesi Street 33, 20052 Monza, Italy
Immunity to Human Immunodeficiency Virus (HIV) Infection
Description
The advent of highly active antiretroviral therapy (HAART) provoked a dramatic decrease in AIDS morbidity and mortality in the developed countries through significant reconstitution of the immune function. It is currently believed that normalization of CD4+ T-cell count (i.e., >500 cells/mm3) is necessary to decrease the morbidity and mortality of HIV-infected patients to levels similar to the HIV-uninfected population of the same age and regional provenance. However, major problems still exist: (i) a number of patients do not normalize CD4+ counts notwithstanding sustained virological control of the HIV replications for many years, (ii) deficits of the immune function and immune activation persist even in patients with virological control, and (iii) incomplete immune reconstitution could increase the risk not only of AIDS-related events, but also events not originally related to HIV infection which are emerging as further clinical complications (e.g., myocardial infarction or non-AIDS defining cancers). These complications have been related to aging of the HIV-infected patients, whose immune system displays alterations similar to those found in older people. Therefore, the “immune aging” phenomenon has become one of the most important topics in the immunology research of HIV infection. Moreover, coinfections with other agents (e.g., hepatitis C virus or cytomegalovirus) may influence immune recovery and provoke clinical complications as well. Last but not least, immune therapy and vaccine approaches have been hypothesized as a means to increase CD4+ T-cell count and improve immune function in patients with suboptimal immune responses after HAART, and this requires further studies. Potential topics include, but are not limited to:
- HIV pathogenesis with focus on immune activation and the “immune-aging” phenomenon
- Reconstitution of the immune function after HAART and possible causes of suboptimal immune responses
- Influence of coinfections (e.g., hepatitis C virus, cytomegalovirus) on subverting the immune function in HIV-infected patients
- Immune correlates of emerging diseases in HIV patients (e.g., metabolic disorders, non-AIDS-related cancers)
- Identification of immune markers that may predict AIDS and non-AIDS-related complications
- Development of immunotherapeutic and vaccine strategies to boost immunity in patients infected with HIV virus
- Characterization of different patterns of immunological alterations and evolution in relation to virological aspects (e.g., viral tropism, HIV load, HIV subtypes) during the natural history and after HAART
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