Immune activation and Immunopathology of the HIV infection：免疫激活和HIV感染的免疫病理学.pptVIP

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Immune activation and Immunopathology of the HIV infection：免疫激活和HIV感染的免疫病理学.ppt

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Immune activation and Immunopathology of the HIV infection：免疫激活和HIV感染的免疫病理学

New concepts in HIV Immunology Pr Brigitte AUTRAN Lab. Immunité et Infections, INSERM U945 Institut Fédératif de Recherches Immunité-Cancer-Infection H?pital Pitié-Salpétrière Université Pierre et Marie Curie, Paris brigitte.autran@psl.aphp.fr B Autran EACS 10 1981 - 1997 - 2007 : AIDS and Immune Deficiencies : The (only?) Complication of the HIV infection, occurring despite strong immune responses to HIV Immune Reconstitution with ARV B Autran EACS 09 Réponses Immunes Cellules CD4/mm3 Charge VIH 200 SIDA Infections Opportunistes ARV 1997 – 2006: Limitations of ARV : Partial restoration of Immunity to HIV = Concepts : ??auto-vaccination?? by treatment interruption (STI) Primo-infection J Lisziewicz et al. ….E. Rosenberg et al., 1989, 2000 CTL CD4 help virus Infection Chronique: G Ortiz et al., G. Carcelain et al. B Hirschel et al. ….. 1989 ….2002 1998 – 2007 : The ??Burial?? of the STI concept : Lack of viral control after repeated STI despite rebounds in immune responses SMART: Increased Frequency of complications HIV-related: opportunistic Infections Cardiovascular: HIV-related ???? Renal Liver All serious non-AIDS CVD Non-AIDS malignancy Other non-AIDS death Adjusted hazard ratio 400 vs. 400 copies/mL 1.0 1.5 0.5 0.2 B Hirschel et al. 2006….. El Sadr et al. 2007 New questions Novel conceptsin the Immunology of the HIV infection Immune activation and Immunopathology of the HIV infection Immune Benefits of Long term antiretroviral therapy ? Immune control of HIV and the dream of HIV eradication … B Autran EACS 09 Current issues in HIV immunolgy Immune activation and Immunopathology of the HIV infection: the vicious circle What’s new ? Current issues: Sources of immune activation? Consequences of immune activation and cardiovascular alterations Markers of immune activation Benefits of ART? Immune Benefits of Long term antiretroviral therapy Immune control of HIV and the dream of HIV eradication …… B Autran EA