Impact of early antiretroviral therapy, early life immunity and immune sex differences on HIV disease and posttreatment control in children.
Impact of early antiretroviral therapy, early life immunity and immune sex differences on HIV disease and posttreatment control in children.
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DOI：
10.1097/coh.0000000000000807
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发表时间：
2023-09-01
影响因子：
4.1
通讯作者：
Goulder, Philip J. R.
中科院分区：
文献类型：
--
作者：
Herbert, Nicholas G.;Goulder, Philip J. R.
关键词：
回顾对影响艾滋病毒感染儿童艾滋病毒疾病进展的因素的最新见解，对比结果：早期开始抗逆转录病毒治疗后与自然抗逆转录病毒治疗（ART）初期感染后的结果；儿童和成人的对比；在女性个体和男性个体之间。在大多数感染艾滋病毒的儿童中，早期免疫极化和与母婴传播艾滋病毒相关的几个因素导致艾滋病毒特异性CD8+ t细胞反应无效和疾病快速进展。然而，在儿童中，同样的因素导致低免疫激活和抗病毒功效，主要通过自然杀伤细胞反应介导，这是治疗后控制的核心特征。相比之下，在成人中，免疫系统的快速激活和广泛的hiv特异性CD8+ t细胞反应的产生，特别是在“保护性”HLA I类分子的背景下，与art初始感染的优越疾病结局相关，但与治疗后控制无关。从子宫内开始，女性个体的免疫激活水平高于男性个体，这增加了女性在子宫内感染艾滋病毒的易感性，可能有利于抗逆转录病毒治疗初期的疾病结果，而不是治疗后的控制。生命早期免疫和与母婴传播相关的因素通常导致未经抗逆转录病毒疗法感染的艾滋病毒疾病快速进展，但有利于早期开始抗逆转录病毒疗法后儿童的治疗后控制。
To review recent insights into the factors affecting HIV disease progression in children living with HIV, contrasting outcomes: following early ART initiation with those in natural, antiretroviral therapy (ART)-naive infection; in children versus adults; and in female individuals versus male individuals. Early life immune polarization and several factors associated with mother-to-child transmission of HIV result in an ineffective HIV-specific CD8+ T-cell response and rapid disease progression in most children living with HIV. However, the same factors result in low immune activation and antiviral efficacy mediated mainly through natural killer cell responses in children and are central features of posttreatment control. By contrast, rapid activation of the immune system and generation of a broad HIV-specific CD8+ T-cell response in adults, especially in the context of ‘protective’ HLA class I molecules, are associated with superior disease outcomes in ART-naive infection but not with posttreatment control. The higher levels of immune activation in female individuals versus male individuals from intrauterine life onwards increase HIV infection susceptibility in females in utero and may favour ART-naive disease outcomes rather than posttreatment control. Early-life immunity and factors associated with mother-to-child transmission typically result in rapid HIV disease progression in ART-naive infection but favour posttreatment control in children following early ART initiation.
影响因子：
3.3
作者：
Tsai MH;Muenchhoff M;Adland E;Carlqvist A;Roider J;Cole DK;Sewell AK;Carlson J;Ndung'u T;Goulder PJ
通讯作者：
Goulder PJ
DOI：
10.1084/jem.20072457
发表时间：
2008-05-12
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Goepfert PA;Lumm W;Farmer P;Matthews P;Prendergast A;Carlson JM;Derdeyn CA;Tang J;Kaslow RA;Bansal A;Yusim K;Heckerman D;Mulenga J;Allen S;Goulder PJ;Hunter E
通讯作者：
Hunter E
影响因子：
3.7
作者：
McKinnon JE;Mailliard RB;Swindells S;Wilkin TJ;Borowski L;Roper JM;Bastow B;Kearney M;Wiegand A;Mellors JW;Rinaldo CR;A5201 study team
通讯作者：
A5201 study team