Hernandez-Vargas Esteban A
Frankfurt Institute for Advanced Studies, Frankfurt am Main, Germany.
Front Immunol. 2017 Aug 28;8:995. doi: 10.3389/fimmu.2017.00995. eCollection 2017.
Although combinatorial antiretroviral therapy (cART) potently suppresses the virus, a sterile or functional cure still remains one of the greatest therapeutic challenges worldwide. Reservoirs are infected cells that can maintain HIV persistence for several years in patients with optimal cART, which is a leading obstacle to eradicate the virus. Despite the significant progress that has been made in our understanding of the diversity of cells that promote HIV persistence, many aspects that are critical to the development of effective therapeutic approaches able to purge the latent CD4+ T cell reservoir are poorly understood. Simultaneous purging strategies known as "kick-kill" have been pointed out as promising therapeutic approaches to eliminate the viral reservoir. However, long-term outcomes of purging strategies as well as the effect on the HIV reservoir are still largely fragmented. In this context, mathematical modeling can provide a rationale not only to evaluate the impact on the HIV reservoir but also to facilitate the formulation of hypotheses about potential therapeutic strategies. This review aims to discuss briefly the most recent mathematical modeling contributions, harnessing our knowledge toward the uncharted territory of HIV eradication. In addition, problems associated with current models are discussed, in particular, mathematical models consider only T cell responses but HIV control may also depend on other cell responses as well as chemokines and cytokines dynamics.
尽管联合抗逆转录病毒疗法(cART)能有效抑制病毒,但实现无菌或功能性治愈仍是全球最大的治疗挑战之一。病毒储存库是指在接受最佳cART治疗的患者中可使HIV持续存在数年的受感染细胞,这是根除病毒的主要障碍。尽管我们在了解促进HIV持续存在的细胞多样性方面取得了重大进展,但对于开发能够清除潜伏性CD4 + T细胞储存库的有效治疗方法至关重要的许多方面仍知之甚少。被称为“激活-杀灭”的同步清除策略已被指出是消除病毒储存库的有前景的治疗方法。然而,清除策略的长期结果以及对HIV储存库的影响在很大程度上仍然不完整。在此背景下,数学建模不仅可以为评估对HIV储存库的影响提供理论依据,还可以促进关于潜在治疗策略的假设的形成。本综述旨在简要讨论最新的数学建模贡献,利用我们的知识探索HIV根除这一未知领域。此外,还讨论了当前模型存在的问题,特别是数学模型仅考虑T细胞反应,但HIV的控制可能还取决于其他细胞反应以及趋化因子和细胞因子的动态变化。