Zhao Li, Galligan Derek C, Lamers Susanna L, Yu Stephanie, Shagrun Lamia, Salemi Marco, McGrath Michael S
Department of Laboratory Science of Virology, School of Public Health, Shandong University, Jinan, 250012, China.
Sci China C Life Sci. 2009 Jul;52(7):651-6. doi: 10.1007/s11427-009-0085-5. Epub 2009 Jul 30.
Highly active antiretroviral treatment (HAART) has had a significant impact on survival of individuals with acquired immunodeficiency syndrome (AIDS); however, with the longer life-span of patients with AIDS, there is increasing prevalence of AIDS dementia complex (ADC) and other non-AIDS-defining illness, and cardiovascular diseases (CVD) are also common. The influence of these varied disease processes on HIV-1 DNA concentration in brain tissues has not been thoroughly assessed in the post-HAART era. The purpose of the current study is to clarify the impacts of ADC and other complications of HIV disease on the viral load in the brains in AIDS patients with post-HARRT. We examined autopsy specimens from the brains of thirteen patients who died from complications of AIDS with quantitative polymerase chain reaction (QPCR). All but one patient had received HAART prior to death since 1995. Two patients died with severe CVD, multiple cerebrovascular atherosclerosis (CVA) throughout the brain and five patients died with ADC. Six patients had no ADC/CVA. A QPCR was used to measure the presence of HIV-1 DNA in six brain tissues (meninges, frontal grey matter, frontal white matter, temporal subcortex, cerebellum and basal ganglia). In the post-HARRT era, for non-ADC/CVA patients, HIV-1 DNA concentration in brain tissues was statistically higher than that in patients with ADC. In a new finding, two patients who suffered from severe CVD, especially CVA, also had high concentrations of HIV-1 in brain compartments not showing ADC related changes. To our knowledge, this is the first report of a relationship between the CVA and HIV-1 viral burden in brain. The current observations suggest that HAART-resistant HIV reservoirs may survive within ADC lesions of the brain as well as the macrophage rich atherosclerosis, which needs to be confirmed by more AIDS cases with CVA.
高效抗逆转录病毒治疗（HAART）对获得性免疫缺陷综合征（AIDS）患者的生存产生了重大影响；然而，随着AIDS患者寿命的延长，艾滋病痴呆综合征（ADC）和其他非AIDS定义疾病的患病率不断上升，心血管疾病（CVD）也很常见。在HAART时代之后，这些不同疾病过程对脑组织中HIV-1 DNA浓度的影响尚未得到充分评估。本研究的目的是阐明ADC和HIV疾病的其他并发症对接受HAART后的AIDS患者脑内病毒载量的影响。我们用定量聚合酶链反应（QPCR）检测了13例死于AIDS并发症患者的脑尸检标本。除1例患者外，所有患者自1995年起在死亡前均接受了HAART治疗。2例患者死于严重的CVD，全脑多发性脑血管动脉粥样硬化（CVA），5例患者死于ADC。6例患者无ADC/CVA。用QPCR检测6个脑组织（脑膜、额叶灰质、额叶白质、颞叶皮质下、小脑和基底神经节）中HIV-1 DNA的存在情况。在HAART时代之后，对于非ADC/CVA患者，脑组织中HIV-1 DNA浓度在统计学上高于ADC患者。一项新发现是，2例患有严重CVD尤其是CVA的患者，在未显示与ADC相关变化的脑区中也有高浓度的HIV-1。据我们所知，这是关于CVA与脑内HIV-1病毒载量之间关系的首次报告。目前的观察结果表明，对HAART耐药的HIV储存库可能在脑ADC病变以及富含巨噬细胞的动脉粥样硬化中存活，这需要更多患有CVA的AIDS病例来证实。
