title: Is there a role for immunotherapy in controlling HIV infection?
abstract: Although HAART restores immune function in patients with HIV infection, restoration is incomplete. Functional restoration is seen primarily in responses to antigens that are prevalent in HIV-infected persons. Immunization is required to restore responses to antigens that are not predictably present. As an exception, HIV-specific responses are also generally not restored despite the prevalence of these antigens. This may be because HIV replication specifically targets and either destroys or renders nonfunctional HIV-reactive CD4+ T cells. Perhaps because HIV selectively targets HIV-reactive immune cells, therapeutic immunization strategies are particularly important areas of investigation in the treatment of HIV disease. Strategies designed to restore HIV-specific CD4+ T-cell function must also enhance the activity of HIV-specific cytolytic T cells, since these are the likely key mediators of defense against HIV replication. Both active immunization strategies and treatment interruption strategies may enhance HIV-specific immune responses. Treatment interruption, by increasing exposure to HIV antigens through heightened HIV replication, also runs the risk of permitting sufficient HIV replication to damage HIV-responsive CD4+ cells as well as enhancing the losses of other CD4+ cell populations that may protect against opportunistic complications of HIV disease. Thus, treatment interruption strategies require careful and sophisticated monitoring and should not be tried at home.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Lederman
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D006678:HIV / Q000276:immunology / Q000502:physiology; D015488:HIV Antigens / Q000276:immunology; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000628:therapy* / Q000821:virology; D006801:Humans; D007167:Immunotherapy; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D019380:Anti-HIV Agents; D015488:HIV Antigens