Adjunct Therapy for CD4(+) T-Cell Recovery, Inflammation and Immune Activation in People Living With HIV: A Systematic Review and Meta-Analysis.
Adjunct Therapy for CD4(+) T-Cell Recovery, Inflammation and Immune Activation in People Living With HIV: A Systematic Review and Meta-Analysis.
复制标题
HIV 感染者 CD4 T 细胞恢复、炎症和免疫激活的辅助治疗：系统评价和荟萃分析 (10.3389/fimmu.2021.632119)
DOI：
10.3389/fimmu.2021.632119
复制
发表时间：
2021
影响因子：
7.3
通讯作者：
Jiang W
中科院分区：
文献类型：
--
作者：
Zhang Y;Jiang T;Li A;Li Z;Hou J;Gao M;Huang X;Su B;Wu H;Zhang T;Jiang W
背景：HIV 感染会导致免疫稳态紊乱，其特点是 CD4+ T 细胞耗竭、免疫激活和炎症。有效的抗逆转录病毒治疗 (ART) 并不能完全恢复艾滋病毒感染者 (PLWH) 的免疫和临床健康。人们已使用各种药物来改善他们的免疫状态和 CD4+ T 细胞计数，但尚未证明任何措施有效。在这里，我们对现有的关于改善 CD4+ T 细胞计数同时减少炎症和免疫激活的临床研究进行了系统回顾和荟萃分析。方法：我们从总共五个电子数据库中检索了可能的相关出版物，并选择了合格的研究，这些研究涉及使用或不使用 ART 的药物治疗对 CD4+ T 细胞计数恢复、炎症和免疫激活的结果。我们特别关注具有良好治疗方案的免疫无反应者。结果：33 篇文章纳入系统评价和荟萃分析。然而，目前尚无安全有效的专门用于改善 CD4+ T 细胞重建的药物。免疫学益处或不良事件主要取决于候选药物使用的安全性、剂量和持续时间，以及是否与ART联合使用。结论：在“安全、联合、充足和长期（SCAL）”原则下，需要替代方法来加速 CD4+ T 细胞的恢复，并防止接受标准 ART 治疗的 PLWH 出现不良的长期结果。
Background: HIV infection results in immune homeostasis perturbations, which is characterized by CD4+ T-cell depletion, immune activation, and inflammation. Effective antiretroviral therapy (ART) does not fully restore immunologic and clinical health in people living with HIV (PLWH). Various drugs have been used to improve their immune status and CD4+ T-cell counts, but no measures have been tested effective. Here we conduct a systematic review and meta-analysis of existing clinical studies on improving CD4+ T-cell count while decreasing inflammation and immune activation. Methods: We retrieved possible relevant publications from a total of five electronic databases and selected eligible studies, which dealt with outcomes of medical therapy for CD4+ T-cell count recovery, inflammation, and immune activation with or without ART. We paid particular attention to immunologic non-responders with a favorable treatment regimen. Results: Thirty-three articles were included in the systematic review and meta-analysis. However, there were no safe and effective medications specific for improving CD4+ T-cell reconstitution. The immunological benefits or adverse events mainly depend on the safety, dosage, and duration of the candidate medication use, as well as whether it is combined with ART. Conclusion: Under the “safe, combined, adequate and long (SCAL)” principles, alternative approaches are needed to accelerate the recovery of CD4+ T-cells, and to prevent adverse long-term outcomes in PLWH with standard ART treatment.
登录
查看更多内容
DOI：
10.1097/qai.0000000000000478
发表时间：
2015-04-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Funderburg NT;Jiang Y;Debanne SM;Labbato D;Juchnowski S;Ferrari B;Clagett B;Robinson J;Lederman MM;McComsey GA
通讯作者：
McComsey GA
DOI：
10.1086/651664
发表时间：
2010-05-01
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Markowitz M;Vaida F;Hare CB;Boden D;Mohri H;Hecht FM;Kalayjian RC;Conrad A;Mildvan D;Aberg J;Hogan C;Kilby JM;Balfour HH Jr;Schafer K;Richman D;Little S
通讯作者：
Little S
影响因子：
3.8
作者：
Hearps, Anna C.;Maisa, Anna;Crowe, Suzanne M.
通讯作者：
Crowe, Suzanne M.
影响因子：
20.3
作者：
Deeks, SG;Kitchen, CMR;Hecht, FM
通讯作者：
Hecht, FM
影响因子：
5.9
作者：
Ashenafi, Senait;Amogne, Wondwossen;Brighenti, Susanna
通讯作者：
Brighenti, Susanna