Polyactin A can increase CD4+T cell counts in HIV-infected individuals with insufficient immunologic response to HAART: is it a reality?

Abstract

To the Editor

The epidemic of HIV/AIDS is still active; the prevention, therapy and control of HIV are still full of challenging, unpredictable and herculean tasks.¹ Recently, with great interest we read the article by Su et al. titled “Polyactin A increases CD4 + T cell counts in HIV-infected individuals with insufficient immunologic response to highly active antiretroviral therapy”,² which was a prospective, randomized, open-label, parallel clinical trial study. This is commendable, however there were few studies on the essential problem with Polyactin A (PAA).

Firstly, the prevalence of the insufficient immunologic response in the highly active antiretroviral therapy (HAART) patients remains high even though the plasma HIV loads had been suppressed successfully,^3,4 and more important is that the insufficient immunologic response is associated with higher mortality. Therefore, researchers had to use some uncertain immune-modulators or change the HAART strategy reluctantly.

Secondly, PAA had been used as an immune-modulator and adjuvant in China for treatment of impaired immunity, especially in cancer and chronic hepatitis B. This paper may be the first clinical evaluation on CD4 + T cell counts in HIV-infected individuals with insufficient immunologic response to HAART and the results provided us a prospect of using PAA for those patients without changing the HAART strategy. The study results had illustrated the effects of PAA on the immunologic response among AIDS patients with insufficient immunologic response to HAART, which would be an important basis for the research on this topic in the future.

Thirdly, in our view, the conclusions of this study have some biases because of some major defects, e.g. sampling and stochastic methods were described clearly; being an open-label study the results of the CD4 + T cell counts had the potential for bias, the central effect had not been calculated in the process of data analysis, etc.

In conclusion, despite the fact that it is an interesting study, we still do believe that the effect of PAA on increasing CD4 + T cell counts in HIV-infected individuals with insufficient immunologic response to HAART is uncertain, and more intensive research should be carried out to explore its clinic effects and mechanisms in the future.

References

Liu

Wang

Liu

. Acquired immunodeficiency syndrome treatment with traditional Chinese medicine in china: opportunity, advancement and challenges. Chin J Integr Med 2013; 19: 563–567.

Liang

. Polyactin A increases CD4+T-cell counts in HIV-infected individuals with insufficient immunologic response to highly active antiretroviral therapy. Int J STD AIDS 2014; 25: 24–28.

Nicastri

Chiesi

Angeletti

. Clinical outcome after 4 years follow-up of HIV-seropositive subjects with incomplete virologic or immunologic response to HAART. J Med Virol 2005; 76: 153–160.

Kaufmann

Perrin

Pantaleo

. CD4T-lymphocyte recovery in individuals with advanced HIV-1 infection receiving potent antiretroviral therapy for 4 years: the Swiss HIV Cohort Study. Arch Intern Med 2003; 163: 2187–2195.