A contemporary view of immunological non-response to highly active antiretroviral therapy

Abstract

HIV-infection is a chronic, incurable disease that actively spreads among all social groups. Highly active antiretroviral therapy, when taken daily, suppresses viral replication, thus contributing to the restoration of the CD4+ T-lymphocytes’ number and functionality, maintaining patients’ health and prolonging their lives. However, every HIV-infected patient starting the treatment faces a significant risk of developing an immunological non-response when, despite the effective viral load suppression, the immune system does not show any signs of recovery. In immunological non-responders, the number of CD4+ T-cells remains low, and the lymphocytes are unable to protect from diseases. The reasons for developing immunological non-response to highly active antiretroviral therapy are poorly understood, which does not allow the advancement of more effective approaches to treat HIV-infection. Nevertheless, the mechanisms that ensure the CD4+ T-cells regeneration are under close attention of researchers.
Scientists from the Perm Federal Research Center made a great contribution to this study. The current brief review presents the main results of the longstanding work fulfilled by the staff of the Laboratory of Ecological Immunology and the Laboratory of Molecular Immunology of the “IEGM UB RAS” aimed at studying the causes and mechanisms of the immunological non-response development. Promising directions for further research are also proposed.