Profound immune consequences for young adults infected with HIV perinatally or during childhood: a cautionary tale regarding adherence to antiretroviral therapy.
Profound immune consequences for young adults infected with HIV perinatally or during childhood: a cautionary tale regarding adherence to antiretroviral therapy.
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对围产期或儿童期感染艾滋病毒的年轻人产生深远的免疫后果：关于坚持抗逆转录病毒治疗的警示故事。
DOI：
10.1097/qad.0000000000002328
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Elahi,Shokrollah
中科院分区：
文献类型：
--
作者：
Williams,DionnaW;Elahi,Shokrollah
抗逆转录病毒疗法（ART）已经使曾经是致命的诊断变成了一种可控制、可忍受的疾病。艾滋病毒感染者现在的寿命足够长，可以与病毒一起老化，预期寿命接近未感染人口。尽管取得了这些进展，但HIV感染者仍受到通常与衰老相关的疾病的困扰，包括神经认知、代谢、心血管疾病和其他非AIDS定义的合并症[1]。这种情况的发生，部分是因为在对抗慢性疾病时发生的免疫系统的持续征税。事实上，在ART面前的病毒持久性已被解释为病毒潜伏期，药物在某些解剖部位/细胞类型中的有效性降低，以及病毒的细胞间传播[2，3]。因此，由于HIV-1感染引起的抗原持久性促进慢性免疫激活、细胞衰老和淋巴细胞生成，导致称为“炎症”的炎症状态，这一概念将促炎环境归因于衰老过程[4]。这种免疫系统的过早加速老化在艾滋病毒感染者中得到了最全面的评估。然而，成年人并不是唯一易受这种“炎症”影响的人群。事实上，在出生时或儿童时期感染艾滋病毒的青少年和年轻人（YAHIC）是需要考虑的重要人群。目前的免疫和病毒学状况的青年围产期或在儿童时期感染艾滋病毒及其协变量还没有得到很好的调查。一些研究表明，YAHIC可能受益于其强大的免疫细胞再生能力，因此避免了HIV-1相关免疫老化现象的有害影响[5]。尽管他们的年龄相对年轻，并且假定他们的生物年龄赋予了主要的免疫状态，但由于在他们的大部分生活中安装抗病毒反应的长期压力，YAHIC可能特别容易受到高级衰老的影响。
Antiretroviral therapy (ART) has rendered what was once a deadly diagnosis into a manageable, tolerable disease. HIV-infected people are now living long enough to age with the virus and have life expectancies approaching that of the uninfected population. Despite these advances, people living with HIVare plagued with disorders that are typically associated with aging, including neurocognitive, metabolic, cardiovascular disorders, and other non-AIDS-defining comorbidities [1]. This occurs, in part, because of the persistent taxing of the immune system that occurs when fighting a chronic illness. In fact, viral persistence in the face of ART has been explained by viral latency, lowered effectiveness of drugs in some anatomical sites/cell types, and cell-to-cell spread of the virus [2, 3]. As a result, antigen persistence due to HIV-1 infection promotes chronic immune activation, cellular senescence, and lymphopoiesis that result in an inflammatory state termed ‘inflammaging’, a concept that attributes a proinflammatory milieu to the aging process [4]. This premature accelerated aging of the immune system has been evaluated most comprehensively in adults living with HIV. However, adults are not the only population susceptible to this ‘inflammaging’profile. Indeed, adolescents and young adults who were infected withHIV at birth or during childhood (YAHIC) are an important population to consider. The current immunological and virological status of youths perinatally or during childhood infected with HIVand their covariables have not been well investigated. Some studies suggested that YAHIC may benefit from their robust immune cells regeneration capacity and therefore avoid the deleterious effects of HIV-1 associated immune-aging phenomenon [5]. Despite their relatively young age, and a presumed prime immunologic state their biologic age confers, YAHIC can be particularly susceptible to an advanced aging profile due to the long-term stress of mounting an antiviral response for the majority of their lives.
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DOI：
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DOI：
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期刊：
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DOI：
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