-
Views
-
Cite
Cite
Sarah C. Sasson, Anthony D. Kelleher, David A. Cooper, The Modern ART of HIV Infection Management: Towards a Tailored Approach to Maximize CD4 T Cell Reconstitution, Clinical Infectious Diseases, Volume 41, Issue 3, 1 August 2005, Pages 373–375, https://doi.org/10.1086/431489
Close - Share Icon Share
Extract
The great success during the 25-year history of HIV infection has been the introduction of combination antiretroviral therapy (ART). First introduced in the mid-1990s, ART greatly inhibits viral replication, often reducing viral loads to undetectable levels, allowing the homeostatic mechanisms of the immune system to at least partially restore the depleted CD4 T cell population [1]. The result has been clinically significant reductions in morbidity and mortality, converting the infection into a chronic condition in persons tolerant of prolonged ART [2]. However, the long-term outcomes of prolonged ART, both clinical and immunological, are not fully understood. Predictors of good response to ART are not fully elucidated. There is recurrent debate regarding the optimal time to commence ART, with current guidelines representing a compromise between maximizing immunological responses and minimizing long-term toxicities, resistance, and cost, while simultaneously judging the right time to intervene before the patient has developed life-threatening immunodeficiency. However, it is becoming increasingly clear that CD4 T cell responses are heterogeneous. Simple algorithms that allowed greater individual tailoring of therapy would be a significant clinical boon.
