Immune control of HIV-1 infection after therapy interruption: immediate versus deferred antiretroviral therapy

Immune control of HIV-1 infection after therapy interruption: immediate versus deferred antiretroviral therapy

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Abstract Background The optimal stage for initiating antiretroviral therapies in HIV-1 bearing patients is still a matter of debate.Methods We present computer simulations of HIV-1 infection aimed at identifying the pro et contra of immediate as compared to deferred Highly Active Antiretroviral Therapy (HAART).Results Our simulations highlight that a prompt specific CD8+ cytotoxic T lymphocytes response CLEANSE is detected when therapy is delayed.Compared to very early initiation of HAART, in deferred treated patients CD8+ T cells manage to mediate the decline of viremia in a shorter time and, at interruption of therapy, the virus experiences a stronger immune pressure.We also observe, however, that the immunological effects of the therapy fade with time in both therapeutic regimens.

Thus, within one year from discontinuation, Batteries - Chargers viral burden recovers to the value at which it would level off in the absence of therapy.In summary, simulations show that immediate therapy does not prolong the disease-free period and does not confer a survival benefit when compared to treatment started during the chronic infection phase.Conclusion Our conclusion is that, since there is no therapy to date that guarantees life-long protection, deferral of therapy should be preferred in order to minimize the risk of adverse effects, the occurrence of drug resistances and the costs of treatment.