aDepartment of Medicine bDepartment of Epidemiology and Biostatistics, University of California cSan Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
AIDS. 2013 Sep 10;27(14):2255-60. doi: 10.1097/QAD.0b013e328362692f.
HIV-infected controllers have provided novel insights into mechanisms of viral control. We investigated the degree to which HIV DNA and RNA are present in gut-associated lymphoid tissue (GALT) of controllers.
Cross-sectional cohort study.
Colorectal biopsy pieces were obtained from five untreated noncontrollers, five ART-suppressed patients, and nine untreated controllers.
Rectal HIV DNA was lower in controllers (median 496 copies/10(6) CD4 T cells) than in untreated noncontrollers (117483 copies/10(6) CD4+ T cells, P = 0.001) and ART-suppressed patients (6116 copies/10(6) CD4 T cells, P = 0.004). Similarly, rectal HIV RNA was lower in controllers (19 copies/10(6) CD4 T cells) than in noncontrollers (15210 copies/10(6) CD4+ T cells, P = 0.001) and ART-suppressed patients (1625 copies/10(6) CD4+ T cells, P = 0.0599). Rectal HIV RNA/DNA ratios were not statistically different between the three groups.
Despite being able to maintain very low plasma HIV RNA levels in the absence of antiretroviral therapy (ART), HIV-infected controllers have readily measurable levels of HIV DNA and RNA in GALT. As expected, controllers had lower rectal HIV DNA and RNA compared with untreated noncontrollers and ART-suppressed individuals. Compared with the mechanisms of 'natural' viral control of controllers, long-term ART does not reduce the total HIV reservoir to the level of controllers.
HIV 感染者控制者为病毒控制机制提供了新的见解。我们研究了 HIV DNA 和 RNA 在肠道相关淋巴组织 (GALT) 中存在的程度。
横断面队列研究。
从五名未经治疗的非控制者、五名接受 ART 抑制的患者和九名未经治疗的控制者中获得直肠活检样本。
控制者的直肠 HIV DNA 水平较低（中位数为 496 拷贝/10(6) CD4 T 细胞），低于未经治疗的非控制者（117483 拷贝/10(6) CD4+ T 细胞，P=0.001）和接受 ART 抑制的患者（6116 拷贝/10(6) CD4 T 细胞，P=0.004）。同样，控制者的直肠 HIV RNA 水平也较低（19 拷贝/10(6) CD4 T 细胞），低于非控制者（15210 拷贝/10(6) CD4+ T 细胞，P=0.001）和接受 ART 抑制的患者（1625 拷贝/10(6) CD4+ T 细胞，P=0.0599）。三组间直肠 HIV RNA/DNA 比值无统计学差异。
尽管在没有抗逆转录病毒治疗 (ART) 的情况下能够维持非常低的血浆 HIV RNA 水平，但 HIV 感染的控制者的 GALT 中仍可检测到 HIV DNA 和 RNA。与未经治疗的非控制者和接受 ART 抑制的个体相比，控制者的直肠 HIV DNA 和 RNA 水平较低。与控制者的“天然”病毒控制机制相比，长期 ART 并未将总 HIV 储库降低到控制者的水平。
