Genetic, virological, infectious, and pharmacological risk factors for CD4⁺ T-cell regeneration failure in HIV-infected subjects receiving ART

Abstract

In 10 to 40% of HIV-infected patients being adherent to highly active antiretroviral therapy (HAART), viral load suppression is not accompanied by a significant increase in the number of CD4+ T-lymphocytes. This phenomenon, known as immunological non-response to treatment, is associated with a high risk of developing AIDS-associated and non-AIDS-associated diseases, as well as premature death. The bases of immunological non-response to HAART are poorly understood, while information on the risk factors for its development is scattered.The aim of the present review is to organize data on non-immune-system risk factors for the development of immunological nonresponse to HAART.Materials and methods. Electronic searching using PubMed, Science Direct, and Scopus were conducted.Results and discussion. The database search delivered information on genetic, virological, infectious, and pharmacological risk factors for the development of immunological non-response to HAART. Each factor contribution might be substantially different. Still, none of them can be considered a trigger mechanism for this phenomenon.Conclusion. Immunological non-response to HAART is a polyetiological condition. Apparently, this phenomenon is based on normally imperceptible immune system features or defects, which manifest during the CD4+ T-cell regeneration.