Qihui Zhou, Biao Zhu
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2016 May 25;45(3):256-60. doi: 10.3785/j.issn.1008-9292.2016.05.06.
Latent reservoir (LR) of HIV is the cells (such as CD4(+)T cell) where HIV is able to hide. These cellular reservoirs are located throughout the body, including the spleen, lymph nodes, gastrointestinal lymphoid tissues, and become the major obstacle to cure HIV infection. To truly cure patients, a new strategy "shock and kill" was put forward by scientists, which is to shock HIV-infected cells out of hidden reservoirs in the body and then kill them. Quantitatively evaluating the size of long-lived LR is essential to this strategy. This paper reviews assays that measure the magnitude of the latent HIV reservoir, including Alu-gag PCR, quantitative viral outgrowth assay (Q-VOA) and tat/rev induced limiting dilution assay(TILDA). Alu-gag PCR can differentiate the integrated and un-integrated HIV DNA, however, it cannot distinguish defective virus from competent virus, leading to overestimate the real size of LR. Q-VOA is based on cell culture, and is the golden standard for measuring the LR since it provides a definitive minimal estimate of reservoir size. Its disadvantages are being more costly, large amount of blood sample required, and underestimating the true size, which was resulted from particles being not released after one round of stimulation. TILDA measures cells with inducible msRNA as these transcripts are absent in latently infected cells but induced upon viral reactivation. It requires small blood sample size, does not need extraction of viral nucleic acids, can be completed in 2 d and covers a wide dynamic range of reservoir sizes, but has the disadvantage of overestimating the true size of LR.
HIV的潜伏库(LR)是HIV能够藏身的细胞(如CD4(+)T细胞)。这些细胞库遍布全身,包括脾脏、淋巴结、胃肠道淋巴组织,成为治愈HIV感染的主要障碍。为了真正治愈患者,科学家们提出了一种新策略“激活并杀死”,即把潜伏在体内的HIV感染细胞从隐藏库中激活,然后杀死它们。定量评估长期存在的LR的大小对该策略至关重要。本文综述了测量潜伏HIV库大小的检测方法,包括Alu-gag PCR、定量病毒增殖检测(Q-VOA)和tat/rev诱导的有限稀释检测(TILDA)。Alu-gag PCR可以区分整合和未整合的HIV DNA,然而,它无法区分缺陷病毒和有活性的病毒,导致高估LR的实际大小。Q-VOA基于细胞培养,是测量LR的金标准,因为它提供了对库大小的明确最小估计。其缺点是成本更高、需要大量血液样本,并且由于一轮刺激后颗粒未释放而低估了真实大小。TILDA测量可诱导的msRNA的细胞,因为这些转录本在潜伏感染的细胞中不存在,但在病毒重新激活时被诱导。它需要少量血液样本,不需要提取病毒核酸,可以在2天内完成,并且涵盖了广泛的库大小动态范围,但有高估LR真实大小的缺点。