Persistent low-level viremia in HIV-1 elite controllers and relationship to immunologic parameters.
Persistent low-level viremia in HIV-1 elite controllers and relationship to immunologic parameters.
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DOI：
10.1086/605446
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发表时间：
2009-09-15
期刊：
影响因子：
--
通讯作者：
Walker BD
中科院分区：
文献类型：
--
作者：
Pereyra F;Palmer S;Miura T;Block BL;Wiegand A;Rothchild AC;Baker B;Rosenberg R;Cutrell E;Seaman MS;Coffin JM;Walker BD
HIV-1精英控制者能够将病毒复制控制在低于商业分析检测极限的水平，但这些个体的实际病毒血症水平尚未得到很好的定义。在这里，我们量化了精英控制者的血浆HIV-1 RNA，并将其与特定的免疫参数相关联。使用实时RT-PCR检测90个精英对照者的血浆HIV- 1 RNA水平，灵敏度为0.2拷贝/ml。检测hiv特异性免疫应答和纵向CD4+ T细胞计数。血浆HIV-1 RNA中位数为2拷贝/ml （IQR为0.2-14拷贝/ml）。对31名精英控制者的纵向分析显示，大多数个体的病毒血症波动幅度为2-5倍；6例持续低于1拷贝/毫升。病毒血症与HIV特异性中和抗体和Western Blot反应性直接相关，但与CD8+ T细胞反应无关。CD4+ T细胞绝对下降在可检测到病毒血症的个体中更为常见（p=0.04）。低水平病毒血症存在于大多数精英控制者中，并与较高的HIV特异性抗体反应相关。CD4+ T细胞绝对损失在病毒血症个体中更为常见，这表明即使是非常低水平的病毒血症也会随着时间的推移产生负面影响。
HIV-1 elite controllers are able to control virus replication to levels below the limits of detection by commercial assays, but the actual level of viremia in these individuals is not well defined. Here we quantify plasma HIV-1 RNA in elite controllers and correlate this with specific immunologic parameters. Plasma HIV- 1 RNA levels were quantified in 90 elite controllers using a real time RT-PCR assay with a sensitivity of 0.2 copies/ml. HIV-specific immune responses and longitudinal CD4+ T cell counts were examined. Median plasma HIV-1 RNA was 2 copies/ml (IQR 0.2–14 copies/ml). Longitudinal analysis of 31 elite controllers showed 2–5 fold fluctuations in viremia in the majority of individuals; 6 had persistent levels below 1 copy/ml. Viremia correlated directly with HIV specific neutralizing antibodies and Western Blot reactivity, but not with CD8+ T cell responses. Absolute CD4+ T cell decline was more common among individuals with detectable viremia (p=0.04). Low-level viremia is present in the majority of elite controllers and is associated with higher HIV specific antibody responses. Absolute CD4+ T cell loss is more common among viremic individuals, suggesting that even very low-level viremia has negative consequences over time.
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影响因子：
5.4
作者：
Miura, Toshiyuki;Brockman, Mark A.;Walker, Bruce D.
通讯作者：
Walker, Bruce D.
影响因子：
6.4
作者：
Hunt, Peter W.;Brenchley, Jason;Deeks, Steven G.
通讯作者：
Deeks, Steven G.
影响因子：
168.9
作者：
Buchbinder, Susan P.;Mehrotra, Devon V.;Duerr, Ann;Fitzgerald, Daniel W.;Mogg, Robin;Li, David;Gilbert, Peter B.;Lama, Javier R.;Marmor, Michael;del Rio, Carlos;McElrath, M. Juliana;Casimiro, Danilo R.;Gottesdiener, Keith M.;Chodakewitz, Jeffrey A.;Corey, Lawrence;Robertson, Michael N.
通讯作者：
Robertson, Michael N.
影响因子：
5.4
作者：
Chen, Huabiao;Piechocka-Trocha, Alicja;Walker, Bruce D.
通讯作者：
Walker, Bruce D.
影响因子：
11.8
作者：
Dinoso, Jason B.;Kim, Scott Y.;Blankson, Joel N.
通讯作者：
Blankson, Joel N.