From the Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore (D.P., C.Z., Y.H.C.), Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick (M.P.), and the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (T.-W.C.) - all in Maryland; the Department of Pediatrics, University of Mississippi Medical Center, Jackson (H.G.); the University of California San Diego, La Jolla, and the Veterans Affairs San Diego Healthcare System, San Diego (M.S., D.R.); and the Department of Pediatrics, Program in Molecular Medicine, and Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester (K.L.).
N Engl J Med. 2013 Nov 7;369(19):1828-35. doi: 10.1056/NEJMoa1302976. Epub 2013 Oct 23.
An infant born to a woman with human immunodeficiency virus type 1 (HIV-1) infection began receiving antiretroviral therapy (ART) 30 hours after birth owing to high-risk exposure. ART was continued when detection of HIV-1 DNA and RNA on repeat testing met the standard diagnostic criteria for infection. After therapy was discontinued (when the child was 18 months of age), levels of plasma HIV-1 RNA, proviral DNA in peripheral-blood mononuclear cells, and HIV-1 antibodies, as assessed by means of clinical assays, remained undetectable in the child through 30 months of age. This case suggests that very early ART in infants may alter the establishment and long-term persistence of HIV-1 infection.
一名感染了人类免疫缺陷病毒 1 型(HIV-1)的女性所生婴儿,由于存在高危暴露,在出生后 30 小时开始接受抗逆转录病毒治疗(ART)。当重复检测符合 HIV-1 感染的标准诊断标准时,继续进行 ART,以检测 HIV-1 DNA 和 RNA。停止治疗后(当孩子 18 个月大时),通过临床检测评估,血浆 HIV-1 RNA 水平、外周血单个核细胞中的前病毒 DNA 和 HIV-1 抗体在该儿童 30 个月龄内仍无法检测到。本病例提示婴儿早期接受 ART 可能改变 HIV-1 感染的建立和长期持续。