[Immunotherapy of HIV infection]

Despite of suppression of HIV-viremia antiretroviral therapy is not able to achieve a complete reconstitution of the immune system in advanced HIV-1-infected patients. In addition, drug therapy can be limited over time by side effects and emergence of drug resistance. This has evoked growing interest in developing immune based therapies of HIV-1 infection. Current strategies for immune reconstitution are focusing on cytokines such as interleukin-2 (IL-2) and "Colony stimulating factors" (CSF). Combinations of IL-2 with antiretroviral drug combinations can induce a significant increase of CD4-counts. However, it has not been proven yet, that IL-2 can restore functional immunocompetence and that it can influence the clinical course of HIV-1-infection. Polyvalent immunoglobulins have been successfully used for the treatment of recurrent bacterial infections. Colony stimulating factors (CSF) can improve neutropenia in HIV-1-infection and there is growing evidence that CSF are useful in the treatment of bacterial infections in patients even with normal leucocyte counts. A variety of different therapeutic vaccines are currently tested in clinical trials. These vaccines could enhance HIV-1-specific immunological effector mechanisms, but so far they had no effect on HIV-1-viremia or on the course of disease. Further studies are necessary to test whether new vaccination strategies in combination with potent antiretroviral drug therapies can contribute to a better long-term control of HIV-1.