A combination antiretroviral therapy (cART) prescribed to patients suffering from human immunodeficiency virus (HIV) can suppress the replication of infected virus as well as significantly slow down the progression of disease, enabling HIV+ individuals to effectively manage the infection for long periods, says a research.One of the manifestations of HIV infection is chronic inflammation in the gut and damage to the gastrointestinal barrier, which is thought to contribute to immune system activation. The findings showed that initiation of cART at the initial stages typically leads to a rapid and significant reduction in viral replication. Further, the blood CD4+ T cell -- a type of white blood cell that fights infection -- count was also found to increase in majority of the patients who receive the cART treatment.However, those individuals who start cART at later stages of the HIV continued to be afflicted with "non-AIDS" comorbidities and diseases, with a shorter life expectancy than age-matched and uninfected controls, the researchers said.
The study suggests that cART when used at the initial stages of the disease may prove to be beneficial to the health of HIV-infected individuals, but also indicates that CD4+ T cell depletion in the gut remains intractable with current therapy, said lead author Jacob Estes from the Frederick National Laboratory for Cancer Research -- a US based research institute.For the research, the team studied the impact of an early cART on gut inflammation in acutely infected HIV patients. They took colon biopsies from patients in acute and chronic infection phases.Prior to the cART treatment, the magnitude of gastrointestinal tract damage, immune activation and inflammation was found to increase, with significantly depleted CD4+ T cells in all the acutely infected groups as compared to HIV-uninfected control participants. While most patients treated during acute infection resolved GI tract inflammation and immune activation back to baseline levels after 24 weeks of cART, most acutely infected participants did not restore their CD4+ T cells even after 96 weeks of cART, said the paper published in the journal JCI Insight.