Andrea Gori

Abstract: The perception of HAART failure in achieving broadest immune reconstitution has further strengthened the rationale to widely explore new adjuvant immunotherapy. Most work has been performed on IL-2, given its potential to correct HIV-driven immune defects, possibly translating in enhanced immune competency. This is a literature review report reviewing different trials on IL-2 immunotherapy in HIV/AIDS in the past ten years through the Cochrane and NIH review database. IL-2 can benefit severely compromised patients, either HAART-naïve or lacking HAART-driven immune rescue. Furthermore, by sparing HAART-related toxicity, IL-2 is indicated within treatment interruptions or immunization protocols. Important clinical insights stem from the IL-2-mediated immune reconstitution, with a rise in long-term peripheral T-cell turnover, survival and functional markers. Furthermore, IL-2 immunotherapy proved to interfere with cytokine networks with specific regulatory functions over T-cell homeostasis and function. Despite the plethora of immunological findings exploring the intriguing hypothesis that IL-2 might contribute to amend the skewed T-cell immunophenotype and cytokine milieu in HIV/AIDS, major question on the actual clinical impact remain unanswered. This review is meant to thoroughly explore the possibility that the immunological advantages described during IL-2 immunotherapy might translate into actual clinical benefits in the treatment of HIV/AIDS disease.