Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy

M.A. French; N. Lenzo; M. John; S.A. Mallal; E.J. McKinnon; I.R. James; P. Price; J.P. Flexman; M-L Tay-Kearney

doi:10.1046/j.1468-1293.2000.00012.x

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Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy

Journal article

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Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy

M.A. French, N. Lenzo, M. John, S.A. Mallal, E.J. McKinnon, I.R. James, P. Price, J.P. Flexman and M-L Tay-Kearney

HIV Medicine, Vol.1(2), pp.107-115

2000

DOI: https://doi.org/10.1046/j.1468-1293.2000.00012.x

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Abstract

Background: To determine if infectious disease events in HIV-infected patients treated with highly active antiretroviral therapy (HAART) are a consequence of the restoration of pathogen-specific immune responses, a single-centre retrospective study of all HIV-infected patients commencing HAART prior to 1 July 1997 was undertaken to determine the incidence, characteristics and time of onset of disease episodes in HAART responders (decrease in plasma HIV RNA of > 1 log10 copies/mL). Methods: Baseline and post-therapy changes in CD4 T-cell counts and HIV RNA were compared in patients with and without disease and delayed-type hypersensitivity responses to mycobacterial antigens were measured in selected patients. Results: Thirty-three of 132 HAART responders (25%) exhibited one or more disease episodes after HAART, related to a pre-existent or subclinical infection by an opportunistic pathogen. Disease episodes were most often related to infections by mycobacteria or herpesviruses but hepatitis C virus (HCV), molluscum contagiosum virus and human papilloma virus were also implicated. They were most common in patients with a baseline CD4 T-cell count of < 50/uL and occurred most often during the first 2 months of therapy and when CD4 T-cell counts were increasing. Mycobacteria- and HCV-related diseases were associated with restoration of pathogen-specific immune responses. Conclusions: We conclude that improved immune function in immunodeficient patients treated with HAART may restore pathogen-specific immune responses and cause inflammation in tissues infected by those pathogens.

Details

Title: Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy
Authors/Creators: M.A. French (Author/Creator) - Departments of Clinical Immunology,
N. Lenzo (Author/Creator) - Departments of Clinical Immunology,
M. John (Author/Creator) - Departments of Clinical Immunology,
S.A. Mallal (Author/Creator) - Departments of Clinical Immunology,
E.J. McKinnon (Author/Creator) - Murdoch University
I.R. James (Author/Creator) - Murdoch University
P. Price (Author/Creator) - Departments of Clinical Immunology,
J.P. Flexman (Author/Creator) - Microbiology and Infectious Diseases and
M-L Tay-Kearney (Author/Creator) - Royal Perth Hospital
Publication Details: HIV Medicine, Vol.1(2), pp.107-115
Publisher: Blackwell Publishing
Identifiers: 991005540886907891
Murdoch Affiliation: Murdoch University
Language: English
Resource Type: Journal article

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