确定全身艾滋病病毒负担及其对治愈策略的影响。

Defining total-body AIDS-virus burden with implications for curative strategies.

作者信息

Estes Jacob D, Kityo Cissy, Ssali Francis, Swainson Louise, Makamdop Krystelle Nganou, Del Prete Gregory Q, Deeks Steven G, Luciw Paul A, Chipman Jeffrey G, Beilman Gregory J, Hoskuldsson Torfi, Khoruts Alexander, Anderson Jodi, Deleage Claire, Jasurda Jacob, Schmidt Thomas E, Hafertepe Michael, Callisto Samuel P, Pearson Hope, Reimann Thomas, Schuster Jared, Schoephoerster Jordan, Southern Peter, Perkey Katherine, Shang Liang, Wietgrefe Stephen W, Fletcher Courtney V, Lifson Jeffrey D, Douek Daniel C, McCune Joseph M, Haase Ashley T, Schacker Timothy W

机构信息

AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, Maryland, USA.

Joint Clinical Research Center, Kampala, Uganda.

出版信息

Nat Med. 2017 Nov;23(11):1271-1276. doi: 10.1038/nm.4411. Epub 2017 Oct 2.

Abstract

In the quest for a functional cure or the eradication of HIV infection, it is necessary to know the sizes of the reservoirs from which infection rebounds after treatment interruption. Thus, we quantified SIV and HIV tissue burdens in tissues of infected nonhuman primates and lymphoid tissue (LT) biopsies from infected humans. Before antiretroviral therapy (ART), LTs contained >98% of the SIV RNA and DNA cells. With ART, the numbers of virus (v) RNA+ cells substantially decreased but remained detectable, and their persistence was associated with relatively lower drug concentrations in LT than in peripheral blood. Prolonged ART also decreased the levels of SIV- and HIV-DNA cells, but the estimated size of the residual tissue burden of 10 vDNA cells potentially containing replication-competent proviruses, along with evidence of continuing virus production in LT despite ART, indicated two important sources for rebound following treatment interruption. The large sizes of these tissue reservoirs underscore challenges in developing 'HIV cure' strategies targeting multiple sources of virus production.

摘要

在寻求功能性治愈或根除HIV感染的过程中,有必要了解治疗中断后感染复发所源自的病毒库的大小。因此,我们对受感染的非人灵长类动物的组织以及受感染人类的淋巴组织(LT)活检样本中的SIV和HIV组织负荷进行了量化。在抗逆转录病毒疗法(ART)之前,LT中含有超过98%的SIV RNA和DNA细胞。接受ART治疗后,病毒(v)RNA+细胞数量大幅减少,但仍可检测到,其持续存在与LT中药物浓度相对低于外周血有关。长期ART治疗也降低了SIV-和HIV-DNA细胞的水平,但估计残留组织负荷大小为10个可能含有具有复制能力的前病毒的vDNA细胞,以及尽管接受ART治疗但LT中仍有持续病毒产生的证据,表明了治疗中断后复发的两个重要来源。这些组织病毒库的规模巨大,凸显了针对多种病毒产生来源制定“HIV治愈”策略所面临的挑战。

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