Rajasuriar Reena, Wright Edwina, Lewin Sharon R
aCentre of Excellence for Research in AIDS (CERiA) bFaculty of Medicine, Department of Pharmacy, University of Malaya, Kuala Lumpur, Malaysia cDepartment of Infectious Diseases, Alfred Hospital and Monash University dCentre for Biomedical Research, Burnet Institute, Victoria, Melbourne, Australia and Peter Doherty Institute for Infection and Immunity.
Curr Opin HIV AIDS. 2015 Jan;10(1):35-42. doi: 10.1097/COH.0000000000000118.
The purpose of this review was to summarize recent studies on the effect of early antiretroviral therapy (ART) in HIV-infected patients on markers of immune activation/inflammation, viral persistence and serious non-AIDS events.
Early ART, initiated within days to months of HIV infection, was associated with marked reduction in T-cell activation often reaching levels observed in HIV-uninfected individuals. However, the impact of early ART on markers of innate immune activation, microbial translocation and inflammation/coagulation was less clear. Early ART has also been associated with a significant reduction in the frequency of latently infected cells, which was greater if ART was initiated within days to weeks rather than months following infection. However, few studies have evaluated the relationship between immune activation and viral reservoirs, specifically following early ART. Early ART may potentially reduce serious non-AIDS events and associated mortality, but most of these studies have extrapolated from changes in surrogate markers, such as CD4 : CD8 ratio.
Early ART was associated with beneficial effects on multiple markers of immune activation, inflammation and viral persistence. Longer term prospective studies are still needed to determine whether early ART translates to a significant reduction in serious non-AIDS events and mortality.
本综述旨在总结近期关于早期抗逆转录病毒治疗（ART）对HIV感染患者免疫激活/炎症标志物、病毒潜伏及严重非艾滋病相关事件影响的研究。
在HIV感染数天至数月内启动的早期ART，与T细胞激活显著降低相关，常达到未感染HIV个体的水平。然而，早期ART对天然免疫激活、微生物易位及炎症/凝血标志物的影响尚不清楚。早期ART还与潜伏感染细胞频率显著降低相关，若在感染后数天至数周而非数月内启动ART，这种降低更明显。然而，很少有研究评估免疫激活与病毒储存库之间的关系，尤其是在早期ART之后。早期ART可能会降低严重非艾滋病相关事件及相关死亡率，但这些研究大多是从替代标志物的变化推断而来，如CD4 : CD8比值。
早期ART对免疫激活、炎症及病毒潜伏的多种标志物具有有益影响。仍需长期前瞻性研究来确定早期ART是否能显著降低严重非艾滋病相关事件及死亡率。
