人类免疫缺陷病毒（HIV）-抗体库估计病毒抑制的围生期 HIV 感染儿童的储存库大小和抗逆转录病毒治疗开始时间。
Human Immunodeficiency Virus (HIV)-Antibody Repertoire Estimates Reservoir Size and Time of Antiretroviral Therapy Initiation in Virally Suppressed Perinatally HIV-Infected Children.
机构信息
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Research Unit in Congenital and Perinatal Infection, Immune and Infectious Diseases Division, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, Rome, Italy.
出版信息
J Pediatric Infect Dis Soc. 2019 Nov 6;8(5):433-438. doi: 10.1093/jpids/piy080.
BACKGROUND
Assays to estimate human immunodeficiency virus (HIV) reservoir size require large amounts of blood, which represents a drawback especially in pediatric settings. We investigated whether HIV-antibody repertoire could estimate the viral reservoir size. Moreover, we assessed the magnitude of HIV-antibody response as a predictor of time of antiretroviral therapy (ART) initiation.
METHODS
Human immunodeficiency virus-antibody responses to 10 different viral proteins were evaluated by HIV Western blot (WB) kit and a WB score was assigned to each patient. Patients were classified in 2 subgroups based on the timing of ART initiation (early treated [ET], 0-24 weeks and late treated [LT], >24 weeks). Human immunodeficiency virus-deoxyribonucleic acid (DNA) was quantified using real-time quantitative polymerase chain reaction on total peripheral blood mononuclear cells. Logistic regression and principal component analysis were built on these data to test the ability of WB score to predict the expected value of HIV-DNA and the timing of ART initiation.
RESULTS
Sixty-nine perinatally HIV-infected children were evaluated. Reduced HIV-specific antibody responses and lower size of HIV-DNA were observed in ET compared with LT patients (P < .001 and P = .02, respectively). We found that WB score correlates with HIV-DNA (P = .032) and timing of ART initiation (P < .001). Based on the logistic regression analysis, we found that WB score can predict the HIV-DNA size and the timing of ART initiation with an Akaike information criterion of -118.13 and -151.51, respectively.
CONCLUSIONS
Western blot score can estimate HIV-DNA size and timing of ART initiation in long-term virally suppressed children. This rapid, inexpensive, and easily reproducible tool can provide useful information to identify potential candidates for HIV remission studies.
背景
评估人类免疫缺陷病毒（HIV）储存库大小的检测方法需要大量血液，这在儿科环境中尤其成问题。我们研究了 HIV 抗体谱系是否可以估计病毒储存库的大小。此外，我们评估了 HIV 抗体反应的幅度作为开始抗逆转录病毒治疗（ART）的预测指标。
方法
通过 HIV 免疫印迹（WB）试剂盒评估了 10 种不同病毒蛋白的 HIV 抗体反应，并为每位患者分配了 WB 评分。根据开始 ART 的时间（早期治疗[ET]，0-24 周和晚期治疗[LT]，>24 周）将患者分为 2 个亚组。使用实时定量聚合酶链反应（PCR）在总外周血单核细胞上定量 HIV 脱氧核糖核酸（DNA）。对这些数据进行逻辑回归和主成分分析，以测试 WB 评分预测 HIV-DNA 的预期值和开始 ART 的时间的能力。
结果
评估了 69 例围产期 HIV 感染的儿童。与 LT 患者相比，ET 患者的 HIV 特异性抗体反应降低，HIV-DNA 大小降低（P <.001 和 P =.02）。我们发现 WB 评分与 HIV-DNA 相关（P =.032）和开始 ART 的时间（P <.001）。基于逻辑回归分析，我们发现 WB 评分可以分别预测 HIV-DNA 大小和开始 ART 的时间，Akaike 信息准则分别为-118.13 和-151.51。
结论
WB 评分可用于估计长期病毒抑制的儿童中 HIV-DNA 大小和开始 ART 的时间。这种快速，廉价且易于复制的工具可以提供有用的信息，以识别潜在的 HIV 缓解研究候选者。
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