Residual HIV-1 infection during antiretroviral therapy: the challenge of viral persistence.
Residual HIV-1 infection during antiretroviral therapy: the challenge of viral persistence.
复制标题
抗逆转录病毒治疗期间残留的 HIV-1 感染：病毒持续存在的挑战。
DOI：
10.1097/00002030-200107060-00002
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Pomerantz,RJ
中科院分区：
文献类型：
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作者：
Pomerantz,RJ
HIV-1 replicates in most untreated infected individuals at high levels throughout the infection, including the clinical quiescent phase. Levels of this active viral replication directly correlate with disease progression and survival [1±4]. Combination therapeutics for HIV-1, or highly active antiretroviral therapy (HAART), has led recently to dramatic decreases in viral replication in vivo to below the clinical limits of detection (ie usually plasma HIV-1 RNA levels below 50±400 copies/ml, depending on the assay system utilized) and reductions in morbidity/mortality, at least in the developed world [5±7]. These therapeutic modalities have completely altered the epidemic in many regions. The era of HAART now allows both clearer investigations of classical questions in human retrovirology, as well as the generation of new clinical problems. Mechanisms of viral latency and hidden orcryptic'viral replication can also now be addressed without thenoise'of active virally producing cells and high levels of cell-free virions [8], as virally suppressive HAARTunveils' viral persistence. Furthermore, approaches towards possible viral eradication or at least long-term remission can be rationally studied. Nonetheless, it is critical to note that true viral eradication may be extremely difficult for many reasons (see below), including the finding that cells other than those in the immune system (eg kidney, heart, etc.) also appear to be infected at low levels with HIV-1 in vivo [1, 9, 10].This review will discuss the mechanisms of HIV-1 persistence in vivo during the treatment of infected individuals with virally suppressive HAART. Both HIV-1 latency and low-level residual viral replication will be discussed in immune-based cells and other potential cellular reservoirs. These viral parameters will be correlated with the problems associated with maintaining long-term control of HIV-1 infections.
