在基于蛋白酶抑制剂（PI）或奈韦拉平的方案进行抑制性抗逆转录病毒治疗（ART）期间的HIV-1 RNA和HIV-1 DNA持续性。
HIV-1 RNA and HIV-1 DNA persistence during suppressive ART with PI-based or nevirapine-based regimens.
作者信息
Kiselinova Maja, Geretti Anna Maria, Malatinkova Eva, Vervisch Karen, Beloukas Apostolos, Messiaen Peter, Bonczkowski Pawel, Trypsteen Wim, Callens Steven, Verhofstede Chris, De Spiegelaere Ward, Vandekerckhove Linos
机构信息
HIV Translational Research Unit (HTRU), Department of Internal Medicine, Ghent University and Ghent University Hospital, Ghent, Belgium.
Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection and Global Health (IGH), University of Liverpool, Liverpool, UK.
出版信息
J Antimicrob Chemother. 2015 Dec;70(12):3311-6. doi: 10.1093/jac/dkv250. Epub 2015 Aug 31.
OBJECTIVES
Whether ART regimens differ in their propensity to allow persistent HIV-1 detection remains unclear. To investigate this, we performed a cross-sectional study to characterize HIV-1 persistence in peripheral blood during suppressive therapy with NRTIs plus a PI or nevirapine.
METHODS
Residual plasma HIV-1 RNA was quantified by real-time PCR. Cell-associated proviral total HIV-1 DNA, unspliced and multiply spliced HIV-1 RNA and 2-long terminal repeat (2-LTR) circles were quantified by digital PCR.
RESULTS
Comparing PI with nevirapine recipients, residual plasma HIV-1 RNA detection rates were 47/80 (58.8%) versus 37/81 (45.7%), with median (IQR) levels of 4 (3-8) versus 4 (3-7) copies/mL (P = 0.207); detection was less likely with longer duration of suppressive ART (P = 0.020), independently of treatment. HIV-1 DNA was detected in all patients, with median levels of 2.3 (IQR 2.0-2.7) versus 2.5 (IQR 2.1-2.7) log10 copies/10(6) PBMCs, respectively; HIV-1 DNA levels were associated with pre-ART viral load (P = 0.004) and with residual HIV-1 RNA (P = 0.034), unspliced HIV-1 RNA (P = 0.001) and 2-LTR circles (P = 0.005), independently of treatment.
CONCLUSIONS
No significant differences were revealed in levels of residual plasma HIV-1 RNA, total HIV-1 DNA or intracellular markers of ongoing virus replication (unspliced and multiply spliced HIV-1 RNA and 2-LTR circles) between treatment groups.
目的
抗逆转录病毒治疗（ART）方案在导致持续检测到HIV-1的倾向方面是否存在差异尚不清楚。为了对此进行研究，我们开展了一项横断面研究，以描述在接受核苷类逆转录酶抑制剂（NRTIs）加蛋白酶抑制剂（PI）或奈韦拉平的抑制性治疗期间外周血中HIV-1的持续性。
方法
通过实时聚合酶链反应（PCR）对残余血浆HIV-1 RNA进行定量。通过数字PCR对细胞相关的前病毒总HIV-1 DNA、未剪接和多重剪接的HIV-1 RNA以及2-长末端重复序列（2-LTR）环进行定量。
结果
比较接受PI和奈韦拉平的患者，残余血浆HIV-1 RNA检测率分别为47/80（58.8%）和37/81（45.7%），中位数（四分位间距）水平分别为4（3 - 8）和4（3 - 7）拷贝/毫升（P = 0.207）；抑制性ART疗程较长时检测到HIV-1的可能性较小（P = 0.020），与治疗方法无关。所有患者均检测到HIV-1 DNA，中位数水平分别为2.3（四分位间距2.0 - 2.7）和2.5（四分位间距2.1 - 2.7）log10拷贝/10⁶外周血单核细胞（PBMCs）；HIV-1 DNA水平与ART前病毒载量（P = 0.004）、残余HIV-1 RNA（P = 0.034）、未剪接的HIV-1 RNA（P = 0.001）和2-LTR环（P = 0.005）相关，与治疗方法无关。
结论
治疗组之间在残余血浆HIV-1 RNA水平、总HIV-1 DNA水平或正在进行病毒复制的细胞内标志物（未剪接和多重剪接的HIV-1 RNA以及2-LTR环）方面未发现显著差异。
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