Research Department of Infection and Population Health, University College London (UCL), Royal Free Campus, London, UK.
Curr Opin HIV AIDS. 2013 Jul;8(4):311-7. doi: 10.1097/COH.0b013e328361fa66.
To review recent published literature around three areas: long-term nonprogression/viral control; predictors of viral load set point/disease progression; and the potential impact of antiretroviral therapy (ART) in early HIV infection.
The natural course of untreated HIV infection varies widely with some HIV-positive individuals able to maintain high CD4 cell counts and/or suppressed viral load in the absence of ART. Although similar, the underlying mechanistic processes leading to long-term nonprogression and viral control are likely to differ. Concerted ongoing research efforts will hopefully identify host factors that are causally related to these phenotypes, thus providing opportunities for the development of novel treatment or preventive strategies. Although there is increasing evidence that initiation of ART during primary infection may prevent the immunological deterioration which would otherwise be seen in untreated HIV infection, recent studies do not address the longer term clinical benefits of ART at this very early stage.
A better understanding of the relative influences of viral, host, and environmental factors on the natural course of HIV infection has the potential to identify novel targets for intervention to prevent and treat HIV-infected persons.
回顾近期发表的文献，重点关注三个方面：长期无进展/病毒控制；病毒载量基准/疾病进展的预测因素；以及抗逆转录病毒疗法（ART）在早期 HIV 感染中的潜在影响。
未经治疗的 HIV 感染的自然病程差异很大，一些 HIV 阳性个体在没有 ART 的情况下能够维持高 CD4 细胞计数和/或抑制病毒载量。尽管相似，但导致长期无进展和病毒控制的潜在机制过程可能不同。持续的协同研究工作有望确定与这些表型有因果关系的宿主因素，从而为开发新的治疗或预防策略提供机会。尽管越来越多的证据表明，在原发性感染期间开始 ART 可能预防未经治疗的 HIV 感染中会出现的免疫恶化，但最近的研究并未解决在这一非常早期阶段开始 ART 的更长期临床获益问题。
更好地了解病毒、宿主和环境因素对 HIV 感染自然病程的相对影响，有可能为预防和治疗 HIV 感染者确定新的干预目标。
