Immunological inefficiency of art in HIV-infected patients

Widespread introduction and early initiation of antiretroviral therapy significantly improves the prognosis in people living with HIV — with an increase in the number of CD4+ T-lymphocytes, the incidence of HIV-related diseases and the mortality rate decreases. Despite suppression of HIV replication, a fraction of ART-treated patients fails to achieve normalization of CD4+ T-cell counts. These patients have an increased risk of clinical progression to AIDS and non-AIDS events. Currently, there are no clear criteria for determining the case of immunological inefficiency of ART. To date, mechanisms of incomplete immune reconstitution in HIV-infected patients have not been fully elucidated. Therefore, in this review, we aim to attract the attention of specialists to this problem — we summarized the results of recent studies and current literature data, described possible mechanisms and risk factors for the development of immunological inefficiency of ART; presented the studied therapeutic strategies aimed at recovering the immunity in HIV-infected patients.