Division of Infectious Diseases, Department of Medicine, University of Washington.
Vaccine and Infectious Disease Division, Fred Hutch.
AIDS. 2018 Sep 24;32(15):2113-2118. doi: 10.1097/QAD.0000000000001948.
We examined specimens from 111 HIV-infected participants virally suppressed on ART for a minimum of 5 years who had donated serial peripheral blood mononuclear cell (PBMC) specimens to the University of Washington/Fred Hutch Center for AIDS Research (CFAR) Specimen Repository. We determined the HIV proviral copy number per million PBMCs, corrected for CD4 cell count, in 477 specimens collected after a minimum of 5 years of follow-up and up to 15.5 years of clinical viral suppression. Generalized estimating equation regression was used to examine the association between the reservoir size and time, age at study entry, antiretroviral regimen, and risk factors for HIV acquisition.
We found that the inter-participant baseline HIV DNA level varied widely between 0.01 and 4.8 pol-copies per microgram genomic DNA and per CD4 cell number/micoliter; the HIV DNA level declined with time (half-life was estimated at 12 years, 95% confidence interval of 6.2-240 years); the HIV DNA level was lower for those who achieved viral suppression at a younger age; and the HIV DNA level was not affected by the specific antiretroviral regimen used to achieve and maintain suppression.
我们检测了 111 名经过至少 5 年 ART 治疗病毒抑制的 HIV 感染者的标本，这些感染者在研究过程中向华盛顿大学/弗雷德哈钦森艾滋病研究中心（CFAR）标本库捐献了连续的外周血单核细胞（PBMC）标本。我们确定了 477 份经过至少 5 年随访且临床病毒抑制时间长达 15.5 年的标本中每百万 PBMC 细胞的 HIV 前病毒拷贝数，该拷贝数经过 CD4 细胞计数校正。我们采用广义估计方程回归分析来检测储库大小与时间、研究开始时的年龄、抗逆转录病毒方案以及 HIV 获得的危险因素之间的关系。
我们发现，参与者的基线 HIV DNA 水平在 0.01 到 4.8 pol-拷贝/微克基因组 DNA 和每 CD4 细胞数/微升之间差异很大；HIV DNA 水平随时间下降（半衰期估计为 12 年，95%置信区间为 6.2-240 年）；在更年轻时实现病毒抑制的患者 HIV DNA 水平更低；HIV DNA 水平不受用于实现和维持抑制的特定抗逆转录病毒方案的影响。
