Graves’ Disease as a Late Manifestation of Immune Reconstitution Syndrome after Highly Active Antiretroviral Therapy in an HIV-1 Infected Patient

Context: Highly active antiretroviral therapy (HAART) inhibits the HIV replication and consequently increases CD4 levels and decreases viral load. This immune system improvement can trigger various immunological phenomena, entity called Immune Reconstitution Syndrome (IRS). Graves’ disease is a late Immune Reconstitution consequence. Patient: We report the case of a 48 years old man with HIV infection who developed Graves’ disease three years after he was on effective HAART because of the Immune Reconstitution Syndrome. At presentation he had a very low CD4 T-cell count (17 cells/μL). When he started HAART he presented a lipodystrophy syndrome. HAART was changed because of the persistent low CD4-T cells count (less than 100 cell/μL). Afterwards serum lipid levels began to decrease and that was the first manifestation of Graves’ disease, which was diagnosed when CD4 T-cells increased up to 343 cell/μL. Our patient developed Graves’ disease 36 months after initiating effective HAART with protease inhibitors which was coincident with viral suppression and a rise of CD4 T cells. Conclusion: The most immunosuppressed patients with a CD4 T cell count less than 100 cells/μL are at greatest risk for the development of Immune Reconstitution Syndrome after HAART initiation. We conclude that clinicians will have to consider the importance of the early diagnosis of thyroid disease to bring an adequate treatment.

Current knowledge on the multiform reconstitution of intestinal stem cell niche

The development of“mini-guts”organoid originates from the identification of Lgr5+intestinal stem cells(ISCs)and circumambient signalings within their specific niche at the crypt bottom.These in vitro self-renewing“mini-guts”,also named enteroids or colonoids,undergo perpetual proliferation and regulated differentiation,which results in a high-performance,self-assembling and physiological organoid platform in diverse areas of intestinal research and therapy.The triumphant reconstitution of ISC niche in vitro also relies on Matrigel,a heterogeneous sarcoma extract.Despite the promising prospect of organoids research,their expanding applications are hampered by the canonical culture pattern,which reveals limitations such as inaccessible lumen,confine scale,batch to batch variation and low reproducibility.The tumor-origin of Matrigel also raises biosafety concerns in clinical treatment.However,the convergence of breakthroughs in cellular biology and bioengineering contribute to multiform reconstitution of the ISC niche.Herein,we review the recent advances in the microfabrication of intestinal organoids on hydrogel systems.

Acute Respiratory Distress Syndrome (ARDS) Case Report after a Caesarean Section Related to the Immune Reconstitution Inflammatory Syndrome

During pregnancy, a cellular immunosuppressant status is produced. It is characterized by anti-inflammatory cellular responses that allow embryonic implantation. The reversal of these changes during the postpartum period may result in overt clinical manifestations of otherwise quiescent or latent infections. We present an Acute Respiratory Distress Syndrome (ARDS) case after a caesarean section related to the Immune Reconstitution Inflammatory Syndrome (IRIS) in a Guinean black woman. The patient was treated with large doses of corticosteroids showing a great clinical and radiological improvement.

Paleogeographic Reconstitution and Tangential Tectonic in the Backland of Tunisian Dorsal (Fahs Area: J. Rouas and Ruissate)

The Tunisian Dorsal backland is the Eastern Atlas side of maghrebides. Field data of Fahs area allowed us to develop new interpretations and to characterize the main structural features of the studied devices (Jebel Rouas and Ruissate). Heritage of Zaghouan accident, Triassic salt movements and strike-direction of major synsedimentary faults are the principal causes and results of the skinned and superimposed geometric architecture, generated by the reversed extensional (Jurassic-Cretaceous) tectonics. The actual geometry of Jebel Rouas and Ruissate represents a fault propagation fold, affecting Jurassic and Cretaceous sets. The backland of this thrust fault defines an imbrications structures of Barremian series. Tectonic records activities show the existence of angular unconformities (Oligocene and Eocene series on the Cretaceous sets considered as bedrock), slumps, tectonic breccias and synsedimentary faults are all of them controlled by a deep major accident;N-S to NE-SW and NW-SE. Features of the study area are probably related first;to the blockage of Zaghouan thrust oriented NE-SW in the foreland;then, to the intense halokinetic activity, which facilitates the layers displacement acting as decollment level. The detailed structural and stratigraphic study of Fahs area and its neighbors shows the presence of an intense tangential tectonic during upper Miocene, affecting Meso-Cenozoic sets, because all the structures involved are sealed by Oligocene and Miocene thinned series. This is accentuated by the existence of different sets of decollment at different depths, which are represented by a displacement to the SE through the backland of the Tunisian Dorsal. We define these features as an imbrication and thrusting Out of sequence system.

Influence of Wheat Protein Contents and Fractions on Dough RheologicalProperties as Determined by Using a Reconstitution Method

A strong gluten wheat cultivar Shannong 12 and a medium-strength wheat cultivar Shannong 11 were used to investigate the effects of wheat protein contents and protein fractions on dough rheological properties using a reconstitution method. The results indicated that the peak height, peak width, peak integral, resistance to extension and area under the curve were increased when protein content increased to 120, 140, and 160% （w/w） of the protein content in the base flours for doughs made from each wheat cultivar. All protein fractions were added to each of the base flours at three levels （0.25, 0.50 and 1.00%, w/w） based upon the protein content. The mixograph dough development time, peak width, and resistance to extension increased when the glutenin, insoluble glutenin, soluble glutenin, and glutenin macropolymer were added and increased systematically with increasing levels of these fractions. Peak integral increased by adding and increasing protein content, however, albumin-globulin had no obvious effects. Extensibility at rupture decreased when the glutenin, insoluble glutenin, soluble glutenin, and glutenin macropolymer were added, and decreased systematically with increasing levels of these fractions. However, extensibility at rupture increased when the monomeric protein, albumin-globulin, and gliadin were added, and increased systematically with increasing levels of these fractions.

Enhancing Effects of Ligustrazine on Expression of CD31 and Hematopoietic Reconstitution in Syngenic Bone Marrow Transplantation of Mice

Summary： The effect of ligustrazine on the expression of CD31 in syngenic bone marrow transplantation （BMT） mice was studied. Fifty-six Balb/c mice were divided into 3 groups： normal control group. BMT control group, and ligustrazine treated group. Syngenic BMT mouse models were established according to the literatures. In BMT control group and the ligustrazine treated group, the mice were given respecxively orally 0.2 mL saline and 2 mg ligustrazine twice a day. On the 7th, 14th, and 21st day after BMT, the mice were killed. The expression of CD31 on the surface of bone marrow nuclear cells （BMNC） was detected by flow cytometry. Peripheral blood leukocytes, platelets and BMNC were counted. Histological observation of bone marrow was made. The results showed thai in ligustrazine treated group the peripheral blood leukocylcs, platelets and BMNC counts, and the expression of CD31 on the day 7, 14, 21 after BMT were higher than in BMTcontrol group （P〈0.01 or P〈0.05）. In conclusion, ligustrazine could obviously enhance the CD31 expression on the surface of BMNC after syngcnic BMT in mice, which may be one of the mecha- nisms underlying the ligustrazine accelerating hematopoietic reconstitution in syngenic BMT.

Hematopoiesis reconstitution and anti-tumor effectiveness of Pai-Neng-Da capsule in acute leukemia patients with haploidentical hematopoietic stem cell transplantation

BACKGROUND With the rapid development of haploidentical hematopoietic stem cell transplantation(haplo-HSCT),primary poor graft function(PGF)has become a lifethreatening complication.Effective therapies for PGF are inconclusive.New Chinese patent medicine Pai-Neng-Da(PND)Capsule exerts dual effect in promoting hematopoiesis recovery and regulating immunity.Still,the application of PND capsule in hematopoietic stem cell transplantation,especially in the haplo-HSCT setting,has not yet been reported.AIM To evaluate the role of PND capsule in acute leukemia patients with haplo-HSCT.METHODS We retrospectively collected data of acute leukemia patients who underwent haplo-HSCT at the Affiliated People’s Hospital of Ningbo University between April 1,2015 and June 30,2020.Twenty-nine consecutive patients received oral PND capsule from the sixth day to the first month after haplo-HSCT were included in the PND group.In addition,31 patients who did not receive PND capsule during haplo-HSCT were included in the non-PND group.Subsequently,we compared the therapeutic efficacy according to the western medical evaluation indexes and Chinese medical symptom scores,and the survival between the PND group and the non-PND group,using the chi-square test,Fisher’s exact test,and the Kaplan-Meier method.RESULTS The duration of platelet engraftment was shorter in the PND group than in the non-PND group(P=0.039).The PND group received a lower frequency of red blood cells and platelet transfusions than the non-PND group(P=0.033 and P=0.035,respectively).In addition,PND capsule marginally reduced the rate of PGF(P=0.027)and relapse(P=0.043).After 33(range,4-106)months of follow-up,the 3-year relapse-free survival(P=0.046)and progression-free survival(P=0.049)were improved in the PND group than in the non-PND group.Also,the therapeutic efficacy of the PND group according to Chinese medical symptom scores was significantly better than that of the non-PND group(P=0.022).Moreover,the adverse events caused by PND capsule were mild.Nevertheless,there were no significant differences in the duration of neutrophil engraftment,the risk of infection within 100 days after haplo-HSCT,the acute graft-versus-host disease,or the 3-year overall survival between the two groups.CONCLUSION PND capsule could promote hematopoiesis reconstitution,improve the therapeutic efficacy of Chinese medical symptom scores,present anti-tumor effectiveness,and prolong the survival of acute leukemia patients with haplo-HSCT.

Effect of Cooking and Reconstitution Methods on the Loss of Bioactive Compounds in Pigmented and Unpigmented Potatoes

Total phenolics, anthocyanins and antioxidant capacity of five coloured/pigmented (AR2009-10, Adirondack Red, Adirondack Blue, Congo, and POROIPG22-1) and two unpigmented potato genotypes (“Anuschka” and “Russet Burbank”) were assessed in fresh (with and without skin) and commercially processed/cooked/reconstituted products. Ascorbate profiles of the seven genotypes also were investigated using fresh tuber/tissue only. The results showed that genotypes greatly varied in their contents of bioactive compounds. Ascorbate profiles of the genotypes were not associated to any particular flesh colour/pigment. However, the pigmented potatoes had 1.5 to 2.5 times more the phenolics, 2 to 3 times more antioxidant capacity and higher levels of anthocyanins (13.98 to 38.57 mg C3GE-100g FW) compared to unpigmented genotypes. No anthocyanins were detected in the unpigmented potatoes. Significant losses of total phenolics, anthocyanins and total antioxidant capacity were found during peeling (18% - 23%), blanching process (40% - 60%) and further cooking/ reconstitution (7% - 12%) with no prominent genotype differences. Together, 65 to 90% of these bioactive compounds were lost during processing. The results suggested that pigmented potatoes contained higher amounts of total phenolics and anthocyanins and blanching step took away the most of the original bioactive compounds.

Study on the Effect of Ligustrazine on Hematopoietic Reconstitution in Bone Marrow Transplantation Mice

To explore tile effects of ligustrazine on hematopoietic reconstitution and its mechanism after bone marrow transplantation (BMT), the allogenic BMT mice were given intra-abdominal injection of 2,mg ligustrazine twice a day. On the 1st, 7th, 14th, and 28th day after BMT, peripheral blood cells and bone marrow nuclear cells (BMNC) were counted, and the histological features were evaluated. On the 7th, 14th, 21st day after BMT, CXCR4 expression on the BMNC was assayed. The results showed that peripheral blood cell counts and BMNC counts in ligustrazine-treated group on the 7th, 14th, 28th day were higher than those in BMT group (P<0. 01 or P<O. 05). The percentage of hematopoietic tissue volume, fat tissue hyperplasia and congestion and dilation degree of microvessel in ligustrazine-treated group on the 7th, 14th, 21st, 28th day was higher than those in BMT group. The CXCR4 expression levels in ligustrazine-treated group were higher than in BMT group (P<0.01 or P<0. 05) on the 7th and 14th day, and were lower than in BMT group on the 21st day (P<0. 01 ). It is concluded that the ligustrazine can accelerate hematopoietic reconstruction, enhance growth of hematopoietic tissues and promote the repair of microvessels. The CXCR4 expres- sion levels on BMNC may be responsible for the effect of ligustrazine.

Role of traditional Chinese medicine in incomplete immune reconstitution of HIV/AIDS:a review

Despite continuous progress,the prevention and treatment of human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)remain the world’s most serious public health challenges.A key problem is the degree of immune function reconstruction after antiretroviral therapy.Antiretroviral therapy has enriched the treatment of HIV/AIDS and improved the present conditions and the life quality of HIV/AIDS patients.However,some patients still fail to achieve normalization of CD4+T lymphocyte counts although persistent virological suppression.These patients are referred to as immunological non-responders,and usually present with severe immunological dysfunction.To date,since the underlying mechanism of incomplete immune reconstitution in HIV/AIDS has not been fully elucidated,remaining to be the focus and difficulties of current research.It is still a challenge to explore a safe,effective,and reliable therapeutic method for immunological non-responders.Due to fewer side effects and lower drug resistance,traditional Chinese medicine is often sought to provide alternative pharmacotherapy for regulating the immunity of immunological non-responders in China.In this review,we aimed at summarizing the latest and most comprehensive information on traditional Chinese medicine therapeutic methods for promoting immune reconstruction.In addition,outlooks and perspectives for possible future research that related are also discussed.

Reconstitution of double-negative T cells after cord blood transplantation and its predictive value for acute graft-versus-host disease

Background:With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation(UCBT),the correlation between immune reconstitution(IR)after UCBT and graft-versus-host disease(GVHD)has been reported successively,but reports on double-negative T(DNT)cell reconstitution and its association with acute GVHD(aGVHD)after UCBT are lacking.Methods:A population-based observational study was conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology,the First Affiliated Hospital of USTC,between August 2018 and June 2021.IR differences were compared between the patients with and without aGVHD.Results:The absolute number of DNT cells in the healthy Chinese population was 109(70-157)/μL,accounting for 5.82(3.98-8.19)%of lymphocytes.DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation.Importantly,the absolute number and percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD within one year(F=4.684,P=0.039 and F=5.583,P=0.026,respectively).In addition,the number of DNT cells in the first month after transplantation decreased significantly with the degree of aGVHD increased,and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD(HR=0.46,95%confidence interval[CI]:0.23-0.93;P=0.031).Conclusions:Compared to the number of DNT cells in Chinese healthy people,the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow.In addition,the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.

Identification of missing CYP450 enzymes involved in paclitaxel biosynthesis and heterologous reconstitution of baccatin III

Paclitaxel,a tetracyclic diterpenoid,has garnered attention for its potent anti-cancer properties and intricate molecular structure,making it a significant target for chemical synthesis and biosynthesis[1].However,its natural sources are extremely limited,as it is derived exclusively from the bark of endangered genus Taxus plants,which contain paclitaxel in very low concentrations(0.01%−0.05%)[2-3].Recent advances in synthetic biology present promising opportunities to enhance paclitaxel levels in Taxus cell cultures or to enable the reconstitution of its production in heterologous hosts,such as yeast or tobacco(Nicotiana benthamiana).

Against all odds:The road to success in the development of human immune reconstitution mice

The mouse genome has a high degree of homology with the human genome,and its physiological,biochemical,and developmental regulation mechanisms are similar to those of humans;therefore,mice are widely used as experimental animals.However,it is undeniable that interspecies differences between humans and mice can lead to experimental errors.The differences in the immune system have become an impor-tant factor limiting current immunological research.The application of immunodefi-cient mice provides a possible solution to these problems.By transplanting human immune cells or tissues,such as peripheral blood mononuclear cells or hematopoietic stem cells,into immunodeficient mice,a human immune system can be reconstituted in the mouse body,and the engrafted immune cells can elicit human-specific immune responses.Researchers have been actively exploring the development and differen-tiation conditions of host recipient animals and grafts in order to achieve better im-mune reconstitution.Through genetic engineering methods,immunodeficient mice can be further modified to provide a favorable developmental and differentiation microenvironment for the grafts.From initially only being able to reconstruct single T lymphocyte lineages,it is now possible to reconstruct lymphoid and myeloid cells,providing important research tools for immunology-related studies.In this review,we compare the differences in immune systems of humans and mice,describe the devel-opment history of human immune reconstitution from the perspectives of immuno-deficient mice and grafts,and discuss the latest advances in enhancing the efficiency of human immune cell reconstitution,aiming to provide important references for im-munological related researches.

Metformin may be a viable adjunctive therapeutic option to potentially enhance immune reconstitution in HIV-positive immunological non-responders

Incomplete immune reconstitution remains a global challenge for human immunodeficiency virus(HIV)treatment in the present era of potent antiretroviral therapy(ART),especially for those individuals referred to as immunological non-responders(INRs),who exhibit dramatically low CD4^(+)T-cell counts despite the use of effective antiretroviral therapy,with long-term inhibition of viral replication.In this review,we provide a critical overview of the concept of ART-treated HIV-positive immunological non-response,and also explain the known mechanisms which could potentially account for the emergence of immunological non-response in some HIV-infected individuals treated with appropriate and effective ART.We found that immune cell exhaustion,combined with chronic inflammation and the HIV-associated dysbiosis syndrome,may represent strategic aspects of the immune response that may be fundamental to incomplete immune recovery.Interestingly,we noted from the literature that metformin exhibits properties and characteristics that may potentially be useful to specifically target immune cell exhaustion,chronic inflammation,and HIV-associated gut dysbiosis syndrome,mechanisms which are now recognized for their critically important complicity in HIV disease-related incomplete immune recovery.In light of evidence discussed in this review,it can be seen that metformin may be of particularly favorable use if utilized as adjunctive treatment in INRs to potentially enhance immune reconstitution.The approach described herein may represent a promising area of therapeutic intervention,aiding in significantly reducing the risk of HIV disease progression and mortality in a particularly vulnerable subgroup of HIV-positive individuals.

Longitudinal analysis of immune reconstitution and metabolic changes in women living with HIV:A real-world observational study

Background:Women comprise more than half of people living with human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS)worldwide and incomplete immune recovery and metabolic abnormalities affect them deeply.Studies of HIV antiretroviral therapy(ART)have a low female representation in China.We aimed to investigate immune reconstitution and metabolic changes of female HIV-positive cohort in China longitudinally.Methods:HIV-positive women who initiated ART from January 2005 to June 2021 and were followed up regularly at least once a year were included in this study.Immunological indicators(cluster of differentiation 4[CD4]counts and CD8 counts),viral load(VL),and metabolic indicators were collected at follow-up.All data were collected from the China Disease Prevention and Control Information System(CDPCIS).VL was tested half a year,1 year after receiving ART,and every other year subsequently according to local policy.CD4/CD8 ratio normalization was considered as the primary outcome and defined as a value≥1.Incidence rate and probability of CD4/CD8 ratio normalization were estimated through per 100 person-years follow-up(PYFU)and Kaplan-Meier curve,respectively.Multivariate Cox regression was used to identify independent risk factors associated with CD4/CD8 ratio normalization.We further studied the rate of dyslipidemia,hyperuricemia,diabetes,liver injury,and renal injury after ART initiation with the chi-squared tests or Fisher’s exact probability tests,and a generalized estimating equation model was used to analyze factors of dyslipidemia and hyperuricemia.Results:A total of 494 female patients with HIV/AIDS started ART within 16 years from January 2005 to June 2021,out of which 301 women were enrolled with a median duration of ART for 4.1 years(interquartile range,2.3-7.0 years).The overall incidence rate of CD4/CD8 ratio normalization was 8.9(95%confidence interval[CI],7.4-10.6)per 100 PYFU,and probabilities of CD4/CD8 normalization after initiating ART at 1 year,2 years,5 years,and 10 years follow-up were 11.7%,23.2%,44.0%,and 59.0%,respectively.Independent risk factors associated with CD4/CD8 normalization were baseline CD4 cell counts<200 cells/μL,CD8 counts>1000 cells/μL,and more than 6 months from the start of combined ART(cART)to first virological suppression.Longitudinally,the rate of hypercholesterolemia(total cholesterol[TC])and high triglyceride(TG)showed an increasing trend,while the rate of low high-density lipoprotein cholesterol(HDL)showed a decreasing trend.The rate of hyperuricemia presented a downtrend at follow-up.Although liver and renal injury and diabetes persisted during ART,the rate was not statistically significant.Older age and protease inhibitors were independent risk factors for increase of TC and TG,and ART duration was an independent factor for elevation of TC and recovery of HDL-C.Conclusions:This study showed that women were more likely to normalize CD4/CD8 ratio in comparison with findings reported in the literature even though immune reconstruction was incomplete.

In-situ structure reconstitution of NiCo2Px for enhanced electrochemical water oxidation

Gaining insight into the structure evolution of transition-metal phosphides during anodic oxidation is significant to understand their oxygen evolution reaction(OER) mechanism, and then design highefficiency transition metal-based catalysts. Herein, NiCo_2P_x nanowires(NWs) vertically grown on Ni foam were adopted as the target to explore the in-situ morphology and chemical component reconstitution during the anodic oxidation. The major factors causing the transformation from NiCo_2P_x into the hierarchical NiCo_2P_x@CoNi(OOH)_x NWs are two competing reactions: the dissolution of NiCo_2P_x NWs and the oxidative re-deposition of dissolved Co^(2+) and Ni^(2+) ions, which is based primarily on the anodic bias applied on NiCo2 Px NWs. The well balance of above competing reactions, and local pH on the surface of NiCo_2P_x NW modulated by the anodic oxidation can serve to control the anodic electrodeposition and rearrangement of metal ions on the surface of NiCo_2P_x NWs, and the immediate conversion into CoNi(OOH)_x. Consequently, the regular hexagonal CoNi(OOH)_x nanosheets grew around NiCo_2P_x NWs.Benefiting from the active catalytic sites on the surface and the sufficient conductivity, the resultant NiCo_2P_x@CoNi(OOH)_x arrays also display good OER activity, in terms of the fast kinetics process, the high energy conversion efficiency, especially the excellent durability. The strategy of in-situ structure reconstitution by electrochemical reaction described here offers a reliable and valid way to construct the highly active systems for various electrocatalytic applications.

Effect of Immune No.2(免疫2号方) on the Immune Reconstitution in Patients with HIV/AIDS after Highly Active Antiretroviral Treatment:A Randomized Double Blind Placebo Controlled Clinical Trial

Objective： To observe the Immune No. 2（免疫2号方）on the immune reconstitution in patients with human immunodeficiency virus or acquired immune deficiency syndrome （HIV/AIDS） after highly active antiretroviral therapy （HAART）. Methods： A randomized, double-blind, placebo-controlled clinical trial was designed. 233 patients falling immune reconstitution after HAART were randomly divided into treatment group （116 cases） and control group （117 cases）, respectively using Immune No. 2 plus HAART and placebo combined with HAART for 6 months. CD4, CD45RA, CD45RO cell numbers, as well as the symptoms, signs and integral improvement rates were observed in order to evaluate the immune reconstitution efficiency. Results： after the intervention for 1 month, the effective rate of the treatment group （18.97%, 22/116） was significantly higher than that of the control group （9.40%, 11/117） （P=0.02）; 3 months after treatment, the effective rate of the treatment group （27.59%, 32/116） was no difference from that of the control group （22.22%, 26/117） （P=0.31）; 6 months after treatment, the effective rate of the treatment group （34.48%, 40/116） was significantly superior to the control group （21.37%, 25/117） （P=0.02）. CD4, CD45RA, CD45RO count of the treatment group was significantly higher than that of the control group （P〈0.05）. The total score of symptoms and signs in the treatment group was significantly lowered compared with the control group （P=0.02）, and the improvement of fatigue, muscle and joint pain, pruritus and shortness of breath in the treatment group was better than the control group （P〈0.05）. Conclusion： Immune No. 2 can effectively improve the numbers of CD4 cells and its subgroups, as well as the main clinical symptoms and signs of patients after HAART, thereby promoting the immune reconstitution.

Clinical outcomes and immune reconstitution in 103 advanced AIDS patients undergoing 12-month highly active antiretroviral therapy

Background Highly active antiretroviral therapy （HAART） produces profound suppression of HIV replication, substantial increase in CD4^＋ T cells, and partial reconstitution of the immune system. However, the numbers of subjects were small in previous Chinese studies. This study evaluated the efficacy and side effects of HAART in Chinese advanced AIDS patients.Methods One hundred and three antiretroviral drug naive AIDS patients were enrolled in this study and were divided into two groups by their baseline CD4^＋ count： 〈 100 cells/μl or ≥ 100 cells/μl. Clinical, virological and immunological outcomes were monitored at baseline and at 1, 3, 6, 9 and 12 months during the course of treatment with HAART.Results One patient died and another was lost from the follow-up. For the remaining 101 HIV/AIDS patients at the 12th month during the HAART, the plasma viral load （VL） was reduced to （3.2±0.7） lg copies/ml, the CD4^＋ count increased to （168 ±51） cells/μl [among which the naive phenotype （CD45RA^＋CD62L^＋） increased to （49 ±27） cells/μl and the memory phenotype （CD45RA^-） increased to （119 ±55） cells/μl], and the percentage of CD4^＋CD28^＋ cells increased. At the same time, there was a significant reduction of CD8^＋ T cell activation. In the 69 patients with the baseline CD4^＋ count 〈100 cells/μl, 37 had a VL 〈50 copies/ml; while in the 34 patients with the baseline CD4^＋ count ≥ 100 cells/μl, 25 had a VL 〈50 copies/ml, the difference between the two groups was statistically significant. The CD4^＋ T cell count showed a two-phase increase during HAART and a significant positive correlation was shown between the change of CD4^＋ count and plasma VL. Over 12 months of HAART, 10 patients had gastrointestinal side effects, 13 peripheral neuritis, 7 hepatic lesions, 8 hematological side effects, 8 skin rashes, 10 lipodystrophy and 1 renal calculus.Conclusions Immune reconstitution as well as the significantly improved clinical outcomes is observed in Chinese advanced AIDS patients after HAART. Side effects are common during HAART and require clinical attention.

Immune Reconstitution of Acquired Immune Deficiency syndrome

Acquired immune deficiency syndrome （AIDS） is a chronic infectious disease,which the patients are infected with human immunodeficiency virus （HIV）.HIV damages the human＇s immune function and causes CD4 cell decline in the number and function.Immune reconstitution is an important treatment to AIDS.Bone marrow transplantation,adoptive immune cell therapy and cytokines infusion can all assist the immune reconstitution;highly active antiretroviral therapy （HAART） can effectively control the virus replication and benefit the immune reconstitution.HAART combined with immunotherapy is an important method of immune reconstitution in AIDS patients.Chinese medicine is playing a more and more important role in immune reconstitution.Immune reconstitution has always been effective in the whole treatment of AIDS.