Potential implication of residual viremia in patients on effective antiretroviral therapy.
Potential implication of residual viremia in patients on effective antiretroviral therapy.
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DOI：
10.1089/aid.2014.0194
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发表时间：
2015
影响因子：
1.5
通讯作者：
G. K. Sahu
中科院分区：
文献类型：
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作者：
G. K. Sahu
目前的抗逆转录病毒疗法（ART）已将病毒血症抑制到低于临床病毒载量测定的检测极限；然而，即使经过长时间的治疗，也不能完全消除体内的病毒血症。血浆HIV-1载量持续维持在极低水平，低于临床检测极限。这种低水平病毒血症（称为“残余病毒血症”）在大多数患者中无法消除，即使在联合抗逆转录病毒治疗方案中添加了一类新的药物，即病毒整合酶抑制剂。目前，抗逆转录病毒治疗患者体内残留病毒血症的细胞来源和临床意义尚不完全清楚。由于在有效的抗逆转录病毒治疗下，残留的血浆病毒通常不会随着时间的推移而进化，因此有一种预测是，在治疗期间，这些病毒会从体内一个或多个稳定但未知的HIV-1储存库持续以低水平释放。这篇综述试图强调残余病毒血症的来源是另一个重要的储存库（即“活性储存库”），不同于众所周知的潜伏在体内的HIV-1储存库，以及为什么它的消除应该是根除HIV-1努力的优先事项。
The current antiretroviral therapy (ART) has suppressed viremia to below the limit of detection of clinical viral load assays; however, it cannot eliminate viremia completely in the body even after prolonged treatment. Plasma HIV-1 loads persist at extremely low levels below the clinical detection limit. This low-level viremia (termed "residual viremia") cannot be abolished in most patients, even after the addition of a new class of drug, i.e., viral integrase inhibitor, to the combined antiretroviral regimens. Neither the cellular source nor the clinical significance of this residual viremia in patients on ART remains fully clear at present. Since residual plasma viruses generally do not evolve with time in the presence of effective ART, one prediction is that these viruses are persistently released at low levels from one or more stable but yet unknown HIV-1 reservoirs in the body during therapy. This review attempts to emphasize the source of residual viremia as another important reservoir (namely, "active reservoir") distinct from the well-known latent HIV-1 reservoir in the body, and why its elimination should be a priority in the effort for HIV-1 eradication.