Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
AIDS Patient Care STDS. 2023 Jun;37(6):284-296. doi: 10.1089/apc.2023.0028. Epub 2023 May 15.
Acquired immunodeficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), has become a heavy burden of disease and an important public health problem in the world. Although current antiretroviral therapy (ART) is effective at suppressing the virus in the blood, HIV still remains in two different types of reservoirs-the latently infected cells (represented by CD4 T cells) and the tissues containing those cells, which may block access to ART, HIV-neutralizing antibodies and latency-reversing agents. The latter is the focus of our review, as blood viral load drops below detectable levels after ART, a deeper and more systematic understanding of the HIV tissue reservoirs is imperative. In this review, we take the lymphoid system (including lymph nodes, gut-associated lymphoid tissue, spleen and bone marrow), nervous system, respiratory system, reproductive system (divided into male and female), urinary system as the order, focusing on the particularity and importance of each tissue in HIV infection, the infection target cell types of each tissue, the specific infection situation of each tissue quantified by HIV DNA or HIV RNA and the evidence of compartmentalization and pharmacokinetics. In summary, we found that the present state of HIV in different tissues has both similarities and differences. In the future, the therapeutic principle we need to follow is to respect the discrepancy on the basis of grasping the commonality. The measures taken to completely eliminate the virus in the whole body cannot be generalized. It is necessary to formulate personalized treatment strategies according to the different characteristics of the HIV in the various tissues, so as to realize the prospect of curing AIDS as soon as possible.
获得性免疫缺陷综合征（AIDS），由人类免疫缺陷病毒（HIV）引起，已成为世界上疾病的沉重负担和重要的公共卫生问题。虽然目前的抗逆转录病毒疗法（ART）在抑制血液中的病毒方面非常有效，但 HIV 仍然存在于两种不同类型的储库中 - 潜伏感染的细胞（以 CD4 T 细胞为代表）和包含这些细胞的组织，这可能会阻止抗逆转录病毒药物、中和 HIV 的抗体和逆转潜伏的药物进入。后者是我们综述的重点，因为在 ART 后血液病毒载量降至检测水平以下，因此需要更深入和系统地了解 HIV 组织储库。在本综述中，我们以淋巴系统（包括淋巴结、肠道相关淋巴组织、脾脏和骨髓）、神经系统、呼吸系统、生殖系统（分为男性和女性）和泌尿系统为顺序，重点介绍每个组织在 HIV 感染中的特殊性和重要性，每个组织的感染靶细胞类型，通过 HIV DNA 或 HIV RNA 定量的每个组织的具体感染情况，以及分隔和药代动力学的证据。总之，我们发现不同组织中 HIV 的现状既有相似之处，也有不同之处。在未来，我们需要遵循的治疗原则是在掌握共性的基础上尊重差异。不能将用于彻底消除全身病毒的措施一概而论。有必要根据各种组织中 HIV 的不同特征制定个性化的治疗策略，以尽快实现治愈艾滋病的前景。
