title: Human immunodeficiency virus and the gastrointestinal immune system: does highly active antiretroviral therapy restore gut immunity?
abstract: While only partial immune reconstitution in gut-associated lymphoid tissue typically occurs following initiation of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) infection, near-complete immune reconstitution has occasionally been described. This review highlights findings from studies examining the effects of HAART and the timing of its initiation on gastrointestinal (GI) CD4+ T-cell recovery. Its effects on specific CD4+ T-cell subtypes, CD8+ T cells, natural killer cells, and immunoglobulins are also described. Finally, the ability of HAART to restore the intestinal epithelial barrier and lymphatic tissue architecture and reduce microbial translocation is addressed. Determining whether HAART has the ability to prevent permanent GI immune damage when commenced in acute HIV infection has implications for the optimal timing of HAART initiation.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada. ccostiniuk@ottawahospital.on.ca
authors.forename: C T
authors.initials: CT
authors.lastname: Costiniuk
authors.forename: J B
authors.initials: JB
authors.lastname: Angel
mesh_terms: D000208:Acute Disease; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D015497:HIV-1; D006801:Humans; D018928:Immunity, Mucosal / Q000187:drug effects*; D007136:Immunoglobulins / Q000096:biosynthesis; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D007694:Killer Cells, Natural / Q000276:immunology / Q000473:pathology; D008221:Lymphoid Tissue / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D007136:Immunoglobulins