Hicks C B, Gay C, Ferrari G
Duke University Medical Center, Department of Medicine, Durham, North Carolina 27710, USA.
Clin Exp Immunol. 2007 Aug;149(2):211-6. doi: 10.1111/j.1365-2249.2007.03437.x. Epub 2007 Jun 21.
The overall value of initiating anti-retroviral therapy during the acute phase of human immunodeficiency virus type 1 (HIV-1) infection remains unclear. From a clinical perspective, the lack of data from controlled randomized clinical trials limits understanding of long-term effects of treatment on the clinical course of HIV infection. Based on available data, the impact of anti-retroviral therapy during acute infection on the immune response against HIV-1 is not particularly encouraging. Recent observations on the very early depletion of lymphocyte reservoirs in the gastrointestinal tract may partially explain the limited benefit of anti-retroviral therapy initiated during the acute phase of HIV-1 infection. This may also help to explain the dichotomy between early observations demonstrating apparent immunological benefit with early anti-retroviral treatment that were associated none the less with inability to control viral replication following treatment interruption.
在1型人类免疫缺陷病毒（HIV-1）感染急性期开始抗逆转录病毒治疗的总体价值仍不明确。从临床角度来看，缺乏对照随机临床试验的数据限制了我们对治疗对HIV感染临床病程长期影响的理解。根据现有数据，急性感染期间抗逆转录病毒治疗对针对HIV-1的免疫反应的影响并不特别令人鼓舞。最近关于胃肠道淋巴细胞库极早期耗竭的观察结果可能部分解释了在HIV-1感染急性期开始抗逆转录病毒治疗益处有限的原因。这也可能有助于解释早期观察结果之间的二分法，即早期抗逆转录病毒治疗显示出明显的免疫学益处，但治疗中断后仍无法控制病毒复制。
