title: Immune restoration and CD4+ T-cell function with antiretroviral therapies.
abstract: OBJECTIVE
  To review the current understanding of the details and mechanisms of immune restoration that follows administration of suppressive antiretroviral therapies to persons with chronic HIV-1 infection.
  
  
  CONCLUSIONS
  A first-phase cellular increase often includes increases in multiple circulating lymphocyte populations and is largely attributable to rapid redistribution of cells from lymphoid tissue. A second slower phase is largely comprised of naïve cell increases that may reflect cells newly produced in the thymus. Improvement in CD4+ cell function is demonstrable but functional restoration is incomplete. Immunization can enhance the restoration of CD4+ cell-dependent responses, and the magnitude of restoration is related in part to the degree to which HIV-1 replication and immune activation are controlled. Despite the incomplete nature of immune restoration seen after suppression of HIV-1 replication in chronic infection, clinical benefits of these responses are reflected in decreased HIV-1-related opportunistic infections and mortality. The effects of these therapies on the occurrence of non-Hodgkins lymphoma are less apparent.
  
  
  CONCLUSIONS
  Suppression of HIV-1 replication results in both laboratory and clinical evidence of immune restoration. Although incomplete, this immune restoration provides 'breathing room' to develop better-tolerated antiviral therapies and therapies designed to enhance immune function.
authors: Division of Infectious Disease, Case Western Reserve University School of Medicine, Center for AIDS Research, University Hospitals of Cleveland, Ohio 44106-5083, USA.
authors: M M
authors: MM
authors: Lederman
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000254:growth & development*; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology
chemical_list: D019380:Anti-HIV Agents