Treating HIV/AIDS by reducing immune system activation: the paradox of immune deficiency and immune hyperactivation

Purpose of review To collect published evidence in support of a novel immune therapeutic approach to reduce the excess of immune activation that ultimately turns into immune deficiency in HIV/AIDS. Recent findings A large body of evidence has been collected in support of the pathogenetic interpretation that prolonged immune overactivation induced by HIV during the course of chronic infection exhausts the immune system and leads to AIDS. Some groups are exploring the possibility of therapeutic interventions to limit the immune system overload. Cytostatic drugs appear promising candidates to achieve the goal, as they restrain cell proliferation without blocking it. At the same time, they do not affect cellular response to antigenic stimulation, and at appropriate dosages are not immune suppressive. Summary Presently available antiretrovirals only partially reduce immune system activation during chronic HIV infection. Further clinical research is warranted to test cytostatic drugs to avert immune overactivation and prevent progression to AIDS.