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Titolo:
Immune dysfunction and immune restoration disease in HIV patients given highly active antiretroviral therapy
Autore:
Price, P; Mathiot, N; Krueger, R; Stone, S; Keane, NM; French, MA;
Indirizzi:
Royal Perth Hosp, Dept Clin Immunol & Biochem Genet, Perth, WA 6001, Australia Royal Perth Hosp Perth WA Australia 6001 Genet, Perth, WA 6001, Australia Univ Western Australia, Dept Pathol, Perth, WA 6009, Australia Univ Western Australia Perth WA Australia 6009 Perth, WA 6009, Australia
Titolo Testata:
JOURNAL OF CLINICAL VIROLOGY
fascicolo: 3, volume: 22, anno: 2001,
pagine: 279 - 287
SICI:
1386-6532(200110)22:3<279:IDAIRD>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
DELTA T-CELLS; HUMAN-IMMUNODEFICIENCY-VIRUS; HEPATITIS-C VIRUS; INFECTED PATIENTS; CYTOMEGALOVIRUS RETINITIS; IN-VIVO; PROTEASE-INHIBITOR; AIDS PATIENTS; TH1 CELLS; GAMMA;
Keywords:
antiretroviral therapy; cytomegalovirus; HIV; human leukocyte antigens; immune restoration; mycobacteria;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Price, P Royal Perth Hosp, Dept Clin Immunol & Biochem Genet, GPO X2213, Perth, WA 6001, Australia Royal Perth Hosp GPO X2213 Perth WA Australia 6001001, Australia
Citazione:
P. Price et al., "Immune dysfunction and immune restoration disease in HIV patients given highly active antiretroviral therapy", J CLIN VIRO, 22(3), 2001, pp. 279-287

Abstract

Background: Some immune defects caused by HIV infection resolve following treatment with highly active antiretroviral therapy (HAART), but residual immune dysfunction may cause disease. Problems with the regulation of the restored immune system in the first six months of treatment can lead to atypical presentations of mycobacterial, cytomegalovirus (CMV), hepatitis B virus or hepatitis C virus (HCV) disease. We defined these conditions as immunerestoration diseases (IRD) and showed that they occur in 30-40% of individuals who begin HAART from low CD4 T cell counts. Objectives: Analysis of immune dysregulation in patients who have responded to HAART. Study design: Patients with successful immune reconstitution following HAART were selectedfrom a database containing details of all patients managed at Royal Perth Hospital (Western Australia) on the basis a CD4 T cell count < 100/mul before HAART and an increase of > 4-fold or to > 200 CD4 T cells/mul. Results: Patients who had experienced an IRD demonstrated increased levels of bioavailable IL-6 and increased expression of CCR5 and CCR3 on monocytes and granulocytes, but numbers of gamma deltaT-cells were similar to patients with similar CD4 T cell counts without an IRD. Carriage of HLA-A2, -B44 was associated with a history of CMV retinitis and/or encephalomyelitis as an IRD, but not with IRD initiated by Mycobacterium sp., cutaneous varicella zoster or herpes simplex infections or HCV. We also identified a patient with Graves' thyrotoxicosis and pronounced lymphadenopathy after HAART, and demonstrated that thyroid stimulating hormone receptor antibody production was associated with an increase in serum soluble CD30, suggesting acquired immune dysregulation. Conclusions: IRD are associated with persistent immune activation, where differences in genetic profiles suggest that distinct pathological mechanisms are responsible for retinitis/encephalomyelitis IRD. Furtherstudies are important as dysregulated T-cell responses may cause disease later in the course of immune reconstitution. (C) 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/10/20 alle ore 21:16:14