Ocular syphilis in an HIV-infected patient: active disease or immune reconstitution syndrome?


ABSTRACT
In patients coinfected with HIV the natural history of syphilis may be altered and the immune defect may account for differences in the host immune response to Treponema pallidum. Anyway many questions remain about interactions between HIV and syphilis during the HAART-related restoration of protective pathogen-specific immune responses. We describe the case of a HIV-positive patient with ocular syphilis who presented an unexpected immune response to coinfection.
Keywords: Ocular syphilis; HIV; Immune reconstitution; HAART.


Articolo presente in – HAART and correlated pathologies n. 7

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Do we still need CD4 T cell count?


ABSTRACT
The relevance of CD4 T cell count as pivotal marker of HIV disease progression and response to HAART is well established. The authors explore the potential role of immunological markers other than CD4 count in the management of HIV-infected individuals, and consider their usefulness and convenience in clinical practice.
Keywords: HIV; CD4 T cells; Immune reconstitution; T cell phenotype and function.


Articolo presente in – HAART and correlated pathologies n. 7

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Immunotherapy in HIV disease: recent developments and future directions


ABSTRACT
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

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