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Curr Opin HIV AIDS. 2010 Mar;5(2):189-93. doi: 10.1097/COH.0b013e32833647d9.

Th17, gut, and HIV: therapeutic implications.

Author information

  • Positive Health Program, San Francisco General Hospital, University of California-San Francisco, 995 Potrero Avenue, San Francisco, CA 94110, USA. phunt@php.ucsf.edu

Abstract

PURPOSE OF REVIEW:

The purpose of this review is to discuss the apparent impact of persistent-immune activation and inflammation on morbidity and mortality among treated HIV-infected individuals, to explore the potential role of Th17 T-cell depletion in this process, and to discuss potential-therapeutic implications.

RECENT FINDINGS:

Although the vast majority of HIV-infected individuals can now achieve and maintain viral suppression with modern-antiretroviral therapy (ART), their life expectancy remains much shorter than the general population and they continue to be at much higher risk for non-AIDS-associated diseases commonly associated with aging (non-AIDS-associated cancer, cardiovascular disease, etc). Abnormal levels of immune activation and inflammation persist despite sustained viral suppression and may drive these clinical events. Although the causes of persistent-immune activation remain incompletely characterized, persistent low-level HIV replication and/or release from latently infected cells in gut-associated lymphoid tissue (GALT) and microbial translocation probably play a major role. Failure to restore Th17 cells in GALT during ART might impair both the recovery of the gut mucosal barrier and the clearance of microbial products.

SUMMARY:

Insights from recent-pathogenesis studies might suggest novel-therapeutic approaches designed to restore Th17 cells in GALT, thereby decreasing microbial translocation, immune activation, and ultimately morbidity and mortality during treated HIV infection.

PMID:
20543599
[PubMed - indexed for MEDLINE]
PMCID:
PMC2917631
Free PMC Article
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