Infection and Immunity Research Group (INIM), Institut Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain.
Infection and Immunity Research Group (INIM), Hospital Universitari de Tarragona Joan XXIII (HJ23), Tarragona, Spain.
Front Immunol. 2023 Aug 15;14:1228795. doi: 10.3389/fimmu.2023.1228795. eCollection 2023.
Antiretroviral therapy (ART) induces persistent suppression of HIV-1 replication and gradual recovery of T-cell counts, and consequently, morbidity and mortality from HIV-related illnesses have been significantly reduced. However, in approximately 30% of people living with HIV (PLHIV) on ART, CD4 T-cell counts fail to normalize despite ART and complete suppression of HIV viral load, resulting in severe immune dysfunction, which may represent an increased risk of clinical progression to AIDS and non-AIDS events as well as increased mortality. These patients are referred to as "immune inadequate responders", "immunodiscordant responders" or "immune nonresponders (INR)". The molecular mechanisms underlying poor CD4 T-cell recovery are still unclear. In this sense, the use of omics sciences has shed light on possible factors involved in the activity and metabolic dysregulation of immune cells during the failure of CD4 T-cell recovery in INR. Moreover, identification of key molecules by omics approaches allows for the proposal of potential biomarkers or therapeutic targets to improve CD4 T-cell recovery and the quality of life of these patients. Hence, this review aimed to summarize the information obtained through different omics concerning the molecular factors and pathways associated with the INR phenotype to better understand the complexity of this immunological status in HIV infection.
抗逆转录病毒疗法 (ART) 可诱导 HIV-1 复制的持续抑制和 T 细胞计数的逐渐恢复,因此,与 HIV 相关疾病的发病率和死亡率已显著降低。然而,在接受 ART 的大约 30%的 HIV 感染者 (PLHIV) 中,尽管 ART 可完全抑制 HIV 病毒载量,但 CD4 T 细胞计数仍无法恢复正常,导致严重的免疫功能障碍,这可能代表着临床进展为 AIDS 和非 AIDS 事件以及死亡率增加的风险增加。这些患者被称为“免疫不足应答者”、“免疫不和谐应答者”或“免疫无应答者 (INR)”。导致 CD4 T 细胞恢复不良的分子机制尚不清楚。从这个意义上说,组学科学的应用揭示了 INR 中 CD4 T 细胞恢复失败时免疫细胞活性和代谢失调可能涉及的因素。此外,通过组学方法鉴定关键分子,可以提出潜在的生物标志物或治疗靶点,以改善 CD4 T 细胞的恢复和这些患者的生活质量。因此,本综述旨在总结通过不同组学获得的关于与 INR 表型相关的分子因素和途径的信息,以更好地理解 HIV 感染中这种免疫状态的复杂性。
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