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Review
. 2022 Jul;45(3):155-172.

Failure of CD4+ T-cell Recovery upon Virally-Effective cART: an Enduring Gap in the Understanding of HIV+ Immunological non-Responders

Valeria Bono  1 , Matteo Augello  1 , Camilla Tincati  1 , Giulia Marchetti  1
Affiliations
  • PMID: 35920870
Free article
Review

Failure of CD4+ T-cell Recovery upon Virally-Effective cART: an Enduring Gap in the Understanding of HIV+ Immunological non-Responders

Valeria Bono et al. New Microbiol. 2022 Jul.
Free article

Abstract

The introduction of cART in the treatment of HIV infection has significantly decreased morbidity and mortality by inducing suppression of viral replication and recovery of CD4+ T-cell counts. How- ever, about 30% of HIV-infected individuals fail to achieve normalization of CD4+ T-cell counts, de- spite antiretroviral therapy and complete suppression of the HIV load: these patients are referred to as "immunological non-responders". Several studies have shown an increased risk of clinical pro- gression to both AIDS and non-AIDS events as well as a higher mortality in these patients. The pathogenetic factors underlying this condition are multiple and none of these alone can exhaustive- ly explain the mechanism of incomplete immune reconstitution. In light of this, the purpose of the present review is to: i) describe in detail the pathogenetic mechanisms that contribute to scarce immune recovery; ii) discuss the higher morbidity and mortality which feature such a condition; iii) take stock of therapeutic strategies used in recent years for these patients.

Keywords: HIV; immunological non-responders; immune reconstitution; CD4+ T-cells.

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