Ragon Institute of MGH, MIT and Harvard, Massachusetts General Hospital, Cambridge, Massachusetts 02139, USA.
Nat Rev Immunol. 2013 Jul;13(7):487-98. doi: 10.1038/nri3478.
Untreated HIV-1 infection typically progresses to AIDS within 10 years, but less than 1% of infected individuals remain healthy and have normal CD4(+) T cell counts and undetectable viral loads; some individuals have remained this way for 35 years and counting. Through a combination of large population studies of cohorts of these 'HIV-1 controllers' and detailed studies of individual patients, a heterogeneous picture has emerged regarding the basis for this remarkable resistance to AIDS progression. In this Review, we highlight the host genetic factors, the viral genetic factors and the immunological factors that are associated with the controller phenotype, we discuss emerging methodological approaches that could facilitate a better understanding of spontaneous HIV-1 immune control in the future, and we delineate implications for a 'functional cure' of HIV-1 infection.
未经治疗的 HIV-1 感染通常会在 10 年内发展为艾滋病，但不到 1%的感染者保持健康，CD4(+)T 细胞计数正常且病毒载量无法检测到；有些个体已经保持这种状态长达 35 年甚至更长时间。通过对这些“HIV-1 控制器”的大型队列进行人群研究以及对个体患者的详细研究，人们对这种对艾滋病进展的显著抵抗力的基础有了一个异质的认识。在这篇综述中，我们强调了与控制器表型相关的宿主遗传因素、病毒遗传因素和免疫因素，我们讨论了未来可能有助于更好地理解自发性 HIV-1 免疫控制的新兴方法学方法，并阐述了对 HIV-1 感染的“功能性治愈”的影响。
