Notermans D W, Pakker N G, Hamann D, Foudraine N A, Kauffmann R H, Meenhorst P L, Goudsmit J, Roos M T, Schellekens P T, Miedema F, Danner S A
National AIDS Therapy Evaluation Centre (NATEC), Academic Medical Centre, 1100 DE, Amsterdam, The Netherlands.
J Infect Dis. 1999 Oct;180(4):1050-6. doi: 10.1086/315013.
Today's antiretroviral combination regimens can induce significant and sustained decreases in human immunodeficiency virus (HIV)-RNA levels, allowing the immune system to recover. To what extent immune reconstitution is possible and what factors determine the outcome have thus far not been resolved. We studied 19 subjects, treated for 2 years with protease inhibitor-containing triple therapy, who had a strong suppression of HIV-RNA levels. CD4+ T-cell numbers increased from medians of 170 to 420x106 cells/L, but in a number of subjects T-cell numbers did not further increase after week 72, without having reached normal values. Long-term CD4+ T-cell change was mainly caused by a slow but continuous increase in naive CD4+ T cells (CD45RA+CD62L+) and was predicted by the baseline number of these cells. Our data indicate that long-term immunological recovery is gradual, even during strong suppression of viral replication, not always complete, and dependent on the preexisting level of naive CD4+ T cells.
如今的抗逆转录病毒联合疗法能够使人类免疫缺陷病毒（HIV）-RNA水平显著且持续下降，从而让免疫系统得以恢复。然而，免疫重建在何种程度上是可行的，以及哪些因素决定其结果，这些问题迄今尚未得到解决。我们研究了19名接受含蛋白酶抑制剂三联疗法治疗2年的受试者，他们的HIV-RNA水平得到了强力抑制。CD4+T细胞数量从中位数170×10⁶个细胞/升增加到了420×10⁶个细胞/升，但在许多受试者中，T细胞数量在第72周后并未进一步增加，且未达到正常值。长期的CD4+T细胞变化主要是由初始CD4+T细胞（CD45RA+CD62L+）缓慢但持续的增加所引起的，并且可由这些细胞的基线数量预测。我们的数据表明，即使在强力抑制病毒复制的过程中，长期的免疫恢复也是渐进的，并不总是完全恢复，且取决于初始CD4+T细胞的原有水平。
