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Mucosal immunity in HIV infection: what can be done to restore gastrointestinal-associated lymphoid tissue function?

George, Michael D.a; Asmuth, David M.a,b

Current Opinion in Infectious Diseases: June 2014 - Volume 27 - Issue 3 - p 275–281
doi: 10.1097/QCO.0000000000000059
PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens

Purpose of review: This review describes the impact of HIV infection on gut-associated lymphoid tissue, the mechanisms for persistent gut-associated lymphoid tissue dysfunction despite effective antiretroviral therapy, and potential strategies to restore gut-associated lymphoid tissue function and promote immune reconstitution.

Recent findings: Recent studies indicate that unresolved microbial translocation and intestinal dysbiosis may continue to promote enteropathy as well as HIV-associated and non-HIV-associated conditions in many HIV patients who otherwise maintain therapeutic control of systemic viral replication.

Summary: Several novel therapeutic approaches to reduce intestinal inflammation and mitigate microbial translocation may hold promise for restoring gastrointestinal health and thereby increasing the efficacy of immune reconstitution in HIV-infected patients undergoing antiretroviral therapy.

aUniversity of California Davis, Davis

bUniversity of California Davis Medical Center, Sacramento, California, USA

Correspondence to David M. Asmuth, MD, Professor, University of California Davis Medical Center, 4150 V Street, PSSB G-500, Sacramento, CA 95617, USA. Tel: +1 916 734 8695; fax: +1 916 734 7766; e-mail: david.asmuth@ucdmc.ucdavis.edu

© 2014 Lippincott Williams & Wilkins, Inc.