LYMPHATIC TISSUE SAMPLING TO QUANTITATE TISSUE ASSOCIATED HIV 1

在最近的III期研究中，使用核苷类似物和 蛋白酶抑制剂，大多数受试者被认为是aviremic作为判断RNA 在某些系列中，通过培养。 我们的团队，使用 AZT/3 TC和奈非那韦的联合治疗在11/11例受试者中达到了这一点 在12周内。 同样，在我们的研究中，几乎所有新感染艾滋病毒的人 接受AZT/3 TC和利托那韦或茚地那韦（均 HIV-1蛋白酶的有效的生物可利用的抑制剂已经成为禽流感， 通过病毒RNA测定和PBMC共培养来确定。但 长期无病毒血症的意义尚不清楚。 本研究将 包括对HIV感染者的淋巴组织进行取样， 至少有9个月的病毒血症。 的 目标是确定是否可以建议选定的受试者 停止治疗。 如果没有证据表明病毒复制活跃， 淋巴组织被发现，这将表明，长期的病毒血症， 是“病毒性枯竭”的征兆“淋巴组织将受到 病毒培养以及PCR和原位PCR技术，以评估 存在活跃的病毒复制。 这些关键数据对于 回答HIV-1感染是否可以在人类宿主中治愈的问题。

In recent Phase-III studies using combinations of nucleoside analogues and protease inhibitors, most subjects were rendered aviremic as judged by RNA determinations and in some series by culture. Our group, using a combination of AZT/3TC and nelfinavir, has achieved this in 11/11 subjects in 12 weeks. Similarly, in our studies nearly all newly HIV-infected subjects treated with AZT/3TC and either ritonavir or indinavir, both potent bioavailable inhibitors of HIV-1 protease have become aviremic as determined by viral RNA determination and PBMC co-culture. However, the significance of prolonged aviremia remains unclear. This study will involve sampling lymphatic tissue of HIV-infected subjects who as a result of treatment have had a period of at least nine months of aviremia. The goal is to determine whether selected subjects may be advised to discontinue treatment. If no evidence of active viral replication in lymphatic tissue were to be found it would suggest that prolonged aviremia is indicative of "viral burnout." Lymphatic tissue will be subjected to viral culture as well as PCR and in-situ PCR techniques to assess for the presence of active viral replication. This critical data is essential to answer the question whether HIV-1 infection can be cured in a human host.