Epidemiologic characteristics and natural history of HIV-1 natural viral suppressors.
Epidemiologic characteristics and natural history of HIV-1 natural viral suppressors.
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DOI：
10.1097/qai.0b013e3181945f1e
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发表时间：
2009-04-01
期刊：
影响因子：
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通讯作者：
Redfield RR
中科院分区：
文献类型：
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作者：
Sajadi MM;Constantine NT;Mann DL;Charurat M;Dadzan E;Kadlecik P;Redfield RR
本研究的目的是详细描述HIV-1天然病毒抑制剂（NVS）的流行病学特征和自然史，NVS是一组HIV-1感染者，在没有治疗的情况下能够将病毒复制抑制到无法检测的水平。符合NVS标准的HIV-1患者被纳入前瞻性研究。NVS的发病率和患病率通过对10年内在一家诊所就诊的所有患者进行图表审查来计算。采用Kaplan-Meier乘积限法计算累积无进展生存概率。40人参加了这项研究。中位诊断年份为1994年，个体表现出中位6.7年的HIV-1病毒抑制和795个细胞/ul的CD 4计数。NVS的发生率为1.1%（95%CI，0.0-2.1），患病率为1.5%（95%CI，0.8-2.1）。只有1名患者（2.5%）出现进展。在符合NVS定义的随访的前10年内，95.1%（95%CI 86.5%-100%）的NVS继续将其病毒载量控制在不可检测的水平。NVS队列多年来表现出显著的稳定性和低进展率。详细评估与持续的HIV-1天然病毒抑制相关的病毒宿主免疫调节因子，以及这种抑制的丧失，有可能为HIV发病机制和未来的免疫调节靶向预防和治疗研究提供重要的新见解。
The objective of this study was to detail the epidemiologic characteristics and natural history of HIV-1 Natural Viral Suppressors (NVS), a cohort of HIV-1 infected individuals who are able to suppress viral replication to undetectable levels in the absence of therapy. HIV-1 patients who met the NVS criteria were enrolled into a prospective study. The incidence and prevalence of NVS were calculated by performing a chart review on all patients seen in one clinic in a 10 year period. Cumulative probability of progression-free survival was calculated by Kaplan-Meier product limit method. Forty individuals enrolled in the study. The median year of diagnosis was 1994, and individuals demonstrated a median 6.7 years of HIV-1 viral suppression and CD4 count of 795 cells/ul. NVS had an incidence of 1.1% (95%CI, 0.0–2.1) and prevalence of 1.5% (95% CI, 0.8–2.1). Only one patient (2.5%) has progressed. Within the first 10 years for follow-up having met the definition of NVS, 95.1% (95% CI 86.5%–100%) of the NVS continued to control their viral loads to undetectable levels. The NVS cohort has demonstrated remarkable stability and a low rate of progression over many years. Detailed evaluations of viral-host immune regulatory factors associated with persistent HIV-1 natural viral suppression, as well as loss of such suppression, has the potential to provide important new insight in HIV pathogenesis and future immune regulatory targeted preventive and therapeutic research.