Courant Institute, New York University, 251 Mercer Street, New York, NY 10012, USA.
J Theor Biol. 2009 Apr 7;257(3):454-9. doi: 10.1016/j.jtbi.2008.12.034. Epub 2009 Jan 8.
We previously reported that in patients treated with highly active antiretroviral therapy (HAART) who achieve viral load (VL) suppression, low fluctuations of viral load over the threshold of detection (viral blips) more than 4 weeks apart occur at random, with a frequency that does not change with longer times of observation. The etiology of viral blips is currently unknown, but viral blip frequency inversely correlates with the decay of the latent reservoir, whose stability has been proposed as the major hurdle to HIV eradication. We show here that the distribution of viral blip amplitudes observed in a group of 272 patients successfully treated with highly active antiretroviral therapy appears to be power-law distributed. Such a distribution can be theoretically generated by randomly sampling the arrival of asynchronous and overlapping elementary pulses of viremia, with asymptotic exponential decay of kinetics, thus suggesting that the low fluctuations of viremia observed in patients during HAART treatment is, in part, a discrete phenomenon consistent with random activation of latently infected cells or release of virus and infected cells into the blood compartment from unknown sites of active viral replication.
我们之前曾报道过,在接受高效抗逆转录病毒治疗(HAART)且病毒载量(VL)得到抑制的患者中,相隔超过 4 周的病毒载量阈值(病毒滴度)的低波动随机发生,且这种频率不会随着观察时间的延长而改变。目前,病毒滴度波动的病因尚不清楚,但病毒滴度波动的频率与潜伏库的衰减呈反比,而潜伏库的稳定性被认为是 HIV 根除的主要障碍。我们在此表明,在一组 272 名成功接受高效抗逆转录病毒治疗的患者中观察到的病毒滴度波动幅度分布似乎呈幂律分布。这种分布可以通过随机抽样异步和重叠的病毒血症基本脉冲的出现来理论上产生,其动力学呈渐近指数衰减,这表明在 HAART 治疗期间患者的低病毒血症波动在一定程度上是一种离散现象,与潜伏感染细胞的随机激活或病毒和感染细胞从未知的活跃病毒复制部位释放到血液隔室一致。