Intensification of antiretroviral therapy with raltegravir or addition of hyperimmune bovine colostrum in HIV-infected patients with suboptimal CD4+ T-cell response: a randomized controlled trial.

@article{Byakwaga2011IntensificationOA,
  title={Intensification of antiretroviral therapy with raltegravir or addition of hyperimmune bovine colostrum in HIV-infected patients with suboptimal CD4+ T-cell response: a randomized controlled trial.},
  author={Helen Byakwaga and Mark D. Kelly and Damian F. J. Purcell and Martyn A French and Janaki Amin and Sharon R. Lewin and Hila Haskelberg and Anthony D. Kelleher and Roger J. Garsia and Mark A Boyd and David A. Cooper and Sean Emery},
  journal={The Journal of infectious diseases},
  year={2011},
  volume={204 10},
  pages={
          1532-40
        }
}
BACKGROUND Despite virally suppressive combination antiretroviral therapy (cART), some HIV-infected patients exhibit suboptimal CD4(+) T-cell recovery. This study aimed to determine the effect of intensification of cART with raltegravir or addition of hyperimmune bovine colostrum (HIBC) on CD4(+) T-cell count in such patients. METHODS We randomized 75 patients to 4 treatment groups to receive raltegravir, HIBC, placebo, or both raltegravir and HIBC in a factorial, double-blind study. The… 
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Early but limited effects of raltegravir intensification on CD4 T cell reconstitution in HIV-infected patients with an immunodiscordant response to antiretroviral therapy.
TLDR
Raltegravir intensification modestly impacts viral dynamics and induces a rapid but limited gain in CD4 T cell counts in immunodiscordant patients.
Raltegravir intensification shows differing effects on CD8 and CD4 T cells in HIV-infected HAART-suppressed individuals with poor CD4 T-cell recovery
TLDR
Long-term raltegravir intensification failed to counterbalanceCD4 T-cell deficiency and its associated features: hyperactivation and death of CD4 T cells, suggesting a beneficial effect on CD8 T- cell hyperactivation, which has been linked with HIV-associated comorbidities.
The immunomodulatory nutritional intervention NR100157 reduced CD4+ T-cell decline and immune activation: a 1-year multicenter randomized controlled double-blind trial in HIV-infected persons not receiving antiretroviral therapy (The BITE Study).
  • P. Cahn, K. Ruxrungtham, +8 authors J. Lange
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2013
TLDR
The specific immunonutritional product NR100157 significantly reduces CD 4(+) decline in HIV-1-infected individuals, and this is associated with decreased levels of CD4(+)CD25(+), which in turn translates positively to systemic effects.
Effect of therapeutic intensification followed by HIV DNA prime and rAd5 boost vaccination on HIV-specific immunity and HIV reservoir (EraMune 02): a multicentre randomised clinical trial.
Dynamics of CD8 T-Cell Activation After Discontinuation of HIV Treatment Intensification
TLDR
CD8 T-cell activation undergoes reversible changes during raltegravir intensification and discontinuation in patients showing detectable 2-LTR circles, suggesting that raltravir impacts subjects irrespective of 2- LTR detection.
Improvements in Immune Function and Activation with 48-Week Darunavir/Ritonavir-Based Therapy: GRACE Substudy
TLDR
Darunavir/ritonavir-based therapy demonstrated improvements in CD4+ cell recovery and association with progressive functional immune recovery over 48 weeks.
Different Plasma Markers of Inflammation Are Influenced by Immune Recovery and cART Composition or Intensification in Treated HIV Infected Individuals
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The inflammatory profile in treated HIV-infected individuals showed a complex association with HCV co-infection, the levels of CD4 T cells and the cART regimen, highlighting the link between cART composition and residual viral replication.
Incomplete Immune Recovery in HIV Infection: Mechanisms, Relevance for Clinical Care, and Possible Solutions
TLDR
The known and unknown factors regarding the incomplete immune reconstitution in HIV infection are summarized, including mechanisms, relevance for clinical care, and possible solutions.
Antiretroviral therapy suppressed participants with low CD4+ T-cell counts segregate according to opposite immunological phenotypes
TLDR
A cutoff value of CD4+ T-cell count 400 cells/&mgr;l classified better immunodiscordant and immunoconcordant individuals than any &Dgr;CD4 classification.
Do Combination Antiretroviral Therapy Regimens for HIV Infection Feature Diverse T-Cell Phenotypes and Inflammatory Profiles?
TLDR
Questions still remain as to whether an early introduction of cART, specifically in the acute stage of disease, or newer drugs and novel dual drug regimens are able to significantly impact the quality of immune reconstitution and the risk of disease progression in HIV-infected subjects.
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