AIDS Reference Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium.
Curr Opin HIV AIDS. 2012 Sep;7(5):432-9. doi: 10.1097/COH.0b013e328356f6f2.
Primary HIV-1 infection is usually initiated by viruses with an exclusive affinity for the C-C chemokine receptor type 5 (CCR5) coreceptor. Viral variants that are also able to bind the C-X-C chemokine receptor type 4 (CXCR4) coreceptor arise during the course of the disease in about 50% of the infected individuals and their emergence is associated with a faster disease progression. In this article we provide a historical overview of the events that led to the discovery of the relationship between viral phenotype, coreceptor tropism and pathogenesis.
The prevalence of CCR5 and CXCR4-using viruses differs from study to study, but overall percentages of CXCR4 use fluctuate between 2.0 and 63.0%. The association between coreceptor use and disease stage is recognized, with the lowest X4 prevalence in seroconverters and the highest in the final stage of the disease. Up to date there are insufficient arguments to support an impact of coreceptor tropism on response to combined antiretroviral therapy (cART) or an impact of cART on coreceptor tropism evolution.
This review provides an overview of available data on coreceptor use in the different stages of the HIV-1 infection process. Although it is clear that CXCR4-using viruses emerge during the course of infection, the driving forces and mechanisms behind coreceptor switch remain largely unknown.
原发性 HIV-1 感染通常由对 C-C 趋化因子受体 5（CCR5）核心受体具有独特亲和力的病毒引发。在疾病进程中，约 50%的感染者会产生能够结合 C-X-C 趋化因子受体 4（CXCR4）核心受体的病毒变异体，其出现与疾病的快速进展相关。本文对导致发现病毒表型、核心受体嗜性与发病机制之间关系的事件进行了历史回顾。
不同研究中 CCR5 和 CXCR4 使用病毒的流行率不同，但总体上 CXCR4 使用的百分比在 2.0%至 63.0%之间波动。核心受体使用与疾病阶段的关联已被认识到，在血清转换者中 X4 的流行率最低，在疾病的最后阶段最高。迄今为止，尚无充分的论据支持核心受体嗜性对联合抗逆转录病毒治疗（cART）反应的影响，或 cART 对核心受体嗜性演变的影响。
本综述提供了对 HIV-1 感染过程不同阶段核心受体使用的现有数据的概述。虽然很明显，CXCR4 使用病毒是在感染过程中出现的，但核心受体转换背后的驱动力和机制在很大程度上仍然未知。
