Lafeuillade Alain, Cheret Antoine, Hittinger Gilles, Bernardini David, Cuquemelle Caroline, Jullian Eric, Poggi Cécile
Department of Infectious Diseases, General Hospital, Toulon, France.
HIV Clin Trials. 2009 Sep-Oct;10(5):324-7. doi: 10.1310/hct1005-324.
Gut-associated lymphoid tissue is a huge reservoir for HIV-1. Developing new strategies to target "residual" HIV-1 in patients on effective therapy brings the need for an evaluation of tissue reservoirs in the clinic. We measured cell-associated HIV-1 RNA and DNA in blood and rectal biopsies from 23 patients, including 14 with undetectable viremia on HAART, by using an adaptation of commercially available tests. Rectal cell HIV-1 RNA was detected in all viremic patients, with median levels of 4.90 log(10) copies/million CD4. Although plasma viremia was found at a median of 3 copies/mL in "aviremic" patients, rectal cell HIV-1 RNA was detected in 28.5% with median levels of 5.17 log(10) copies/million CD4. Consequently, we propose to use this marker in future clinical trials targeting "residual" HIV-1 in patients with viremia below the detection limit.
肠道相关淋巴组织是HIV-1的一个巨大储存库。制定新策略以靶向接受有效治疗患者体内的“残留”HIV-1，这就需要在临床上评估组织储存库。我们采用市售检测方法的改良版，检测了23名患者血液和直肠活检组织中与细胞相关的HIV-1 RNA和DNA，其中包括14名接受高效抗逆转录病毒治疗（HAART）后病毒血症检测不到的患者。所有病毒血症患者的直肠细胞中均检测到HIV-1 RNA，中位数水平为4.90 log(10)拷贝/百万CD4。虽然“无病毒血症”患者血浆病毒血症的中位数为3拷贝/毫升，但28.5%的患者直肠细胞中检测到HIV-1 RNA，中位数水平为5.17 log(10)拷贝/百万CD4。因此，我们建议在未来针对病毒血症低于检测限患者体内“残留”HIV-1的临床试验中使用这一标志物。
