Review article| Volume 22, ISSUE 3, P719-740, September 2002

Immune reconstitution

      The term immune reconstitution has been used to describe the recovery of immune function following effective HIV therapy. Early reports on the outcomes of potent antiviral therapy document a rise in CD4 T-cell count, which initially was assumed to indicate an increase in overall immune responsiveness. Subsequently, it was documented that increases in CD4 count also included an increase in naive T-cell subsets and a renewed responsiveness to recall antigens. As explored in this article, the clinical and basic immunologic changes that represent immune reconstitution span a variety of functions and outcomes. This article reviews the outcomes of effective treatment on immune function and the repair of immune organs and addresses new therapies that aim to enhance HIV-specific immunity. Overall, the onset of long-term suppression of viral replication with antiviral therapy has opened a new field of interventions that clearly rests on the ability of the immune system to recover from damage caused by viral replication.
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