Immune restoration: repairing the damage

Richard Jefferys
ACRIA Update, Vol. 11, No. 1, Winter 2001/2002

The ability of Highly Active Antiretroviral Therapy (HAART) to suppress HIV replication, increase CD4 cell counts in the blood, and prevent or delay opportunistic infections is now well documented. Individual responses can vary, toxicities remain a problem and the best time to start HAART continues to be debated, but the overall trend of restored immunity and prevention of illness has come as a welcome surprise.

Many researchers feared that the damage to the immune system caused by HIV would be irreversible, but HAART studies have contradicted this assumption. These studies paint a picture of immune restoration occurring in multiple phases — some fast and others slow and variable — ultimately leading to near-normal immune system function in many individuals.

Research into immune restoration also provides a new opportunity to understand the mechanisms by which HIV damages the immune system, a necessary step for designing therapies that might speed immune recovery or help people whose immunity remains impaired despite HAART.

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