Strategies to limit immune-activation in HIV patients

Alessandra Bandera, Elisa Colella, Giuliano Rizzardini, Andrea Gori, Mario Clerici

Research output: Contribution to journalReview article

Abstract

Introduction: Antiretroviral treatment of HIV infection reduces, but does not eliminate, viral replication and down modulates immune activation. The persistence of low level HIV replication in the host, nevertheless, drives a smouldering degree of immune activation that is observed throughout the natural history of disease and is the main driving force sustaining morbidity and mortality. Areascovered: Early start of antiretroviral therapy (ART) and intensive management of behavioural risk factors are possible but, at best, marginally successful ways to manage immune activation. We review alternative, possible strategies to reduce immune activation in HIV infection including timing of ART initiation and ART intensification to reduce HIV residual viremia; switch of ART to newer molecules with reduced toxicity; use of anti inflammatory/immunomodulatory agents and, finally, interventions aimed at modifying the composition of the microbiota. Expertcommentary: Current therapeutic strategies to limit immune activation are only marginally successful. Because HIV eradication is currently impossible, intensive studies are needed to determine if and how immune activation can be silenced in HIV infection.

Original languageEnglish
Pages (from-to)43-54
Number of pages12
JournalExpert Review of Anti-Infective Therapy
Volume15
Issue number1
Early online dateNov 4 2016
DOIs
Publication statusPublished - Jan 2 2017

Keywords

  • antiretroviral therapy
  • comorbidity
  • HIV
  • immune activation
  • microbial translocation

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

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