Adjuvant immunotherapy, directly targeting the immune system, has been proposed as approach to modulate the immune response in HIV-infected subjects treated with HAART and without immune reconstitution. Most studies have been performed on Interleukin-2 (IL-2), focusing on immunological advantage of IL-2+HAART versus HAART alone in different stages of HIV infection. Preliminary results of two Phase III international studies, SILCAAT and ESPRIT, confirm a significant difference in CD4+ cells count, but underline that this immunological advantage does not reduce the rate of opportunistic infections and death. The authors do not provide any data of IL-2 driven immune reconstitution and this could be a bias in the interpretation of the results. Interleukin-7 (IL-7) Phase I studies are ongoing: the potential interest of IL-7 in the treatment of HIV-infection is based on its crucial role on T cell homeostasis both in thymic output and peripheral T proliferation and survival; despite SILCAAT and ESPRIT data, these studies are continuing. Finally, recently approved new class drugs, CCR5-antagonists, open a new scenario in HAART era: published results confirm an immune reconstitution better than other antiretroviral drugs.
Keywords: Immune reconstitution; Interleukin-2; Interleukin-7; CCR5-antagonists.
Articolo presente in – HAART and correlated pathologies n. 2 –