Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01605; email:
Annu Rev Med. 2016;67:201-13. doi: 10.1146/annurev-med-091114-111159.
Globally, 240,000 infants are newly infected with HIV-1 each year and 3.2 million children are living with the infection. Combination antiretroviral therapy (cART) has reduced HIV-1-related disease and mortality in children but is not curative owing to the early generation of a latent reservoir of long-lived memory CD4(+) T cells bearing replication-competent HIV-1 provirus integrated into cellular DNA. This review focuses on recent advances in our understanding of the establishment of HIV-1 persistence in children and how early initiation of cART in the setting of the developing infant immune system limits the formation of the long-lived latent CD4(+) cell reservoir that remains a barrier to remission or cure.
全球每年有 24 万名婴儿新感染 HIV-1,320 万儿童携带该病毒。联合抗逆转录病毒疗法(cART)降低了儿童中与 HIV-1 相关的疾病和死亡率,但由于早期形成了潜伏的、具有复制能力的 HIV-1 前病毒整合到细胞 DNA 中的长寿记忆 CD4(+)T 细胞库,因此无法治愈。这篇综述重点介绍了我们对儿童中 HIV-1 持续存在的机制的最新认识,以及在婴儿发育中的免疫系统环境下早期开始 cART 治疗如何限制了形成长期潜伏的 CD4(+)细胞库,而这仍然是缓解或治愈的障碍。