The ability of immune system to reconstruction
Posted: Sep 22, 2005
QUESTION:
Hi dear doctors
This is my question,how much is the abilitiy of immune system to reconstruction itself after the HIV attack,for example if the CD4 count is below 350 or 200,or when it is steel in normal range,and I want to know if the that count was too low and then an eradication would be possible,would it have the ability to return to acceptable range?
Thanks a lot
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RESPONSE FROM: 
Thanks for your post.
We know a lot about immune reconstitution following the initiation of HAART. Using HIV complications as a surrogate for immune function, we can say that functional immune reconstitution occurs for most recall antigens (things that our immune system has been exposed to in the past). This is why patients can stop PCP or MAC prophylaxis after their CD4 cells rise.
The nag to this story is that HIV-specific immunity does not seem to become reconstituted to any measurable degree. Hence, if one depends on having HIV-specific immunity to have a meaningful discussion about eradiction, then there's a need (if not imperative) to start HAART while this immunity remains intact-- unfortunately, this window is very brief, perhaps only while the patient is still experiencing seroconversion.
I hope this addresses your concerns. BY
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