Early antiretroviral therapy in children perinatally infected with HIV: a unique opportunity to implement immunotherapeutic approaches to prolong viral remission
Early antiretroviral therapy in children perinatally infected with HIV: a unique opportunity to implement immunotherapeutic approaches to prolong viral remission
复制标题
DOI：
10.1016/s1473-3099(15)00052-3
复制
发表时间：
2015-09-01
影响因子：
56.3
通讯作者：
Rossi, Paolo
中科院分区：
文献类型：
--
作者：
Klein, Nigel;Palma, Paolo;Rossi, Paolo
从使用抗逆转录病毒疗法预防母婴传播到密西西比婴儿的经历暗示了艾滋病毒治愈的可能性，儿科艾滋病毒感染对我们理解艾滋病毒发病机制和管理至关重要。建议感染艾滋病毒的儿童每日服药并无限期接受抗逆转录病毒治疗。维持终生的依从性是困难的，并且在开始抗逆转录病毒治疗后三级病毒学失败的发生率随着时间的推移而增加。这一挑战表明，迫切需要确定新的策略，以提供长期的病毒抑制，这将允许安全中断抗逆转录病毒治疗，而不会出现病毒反弹和任何相关并发症。在出生后几天内接受治疗的HIV感染婴儿具有非常小的整合病毒库，非常高比例的相对HIV抗性幼稚T细胞和无与伦比的再生免疫库的能力的独特组合。这些特征使该组成为研究基于免疫疗法的潜在疗效的最佳模型人群。如果成功，这些研究可能会改变我们管理艾滋病毒感染的方式。
From the use of antiretroviral therapy to prevent mother-to-child transmission to the possibility of HIV cure hinted at by the Mississippi baby experience, paediatric HIV infection has been pivotal to our understanding of HIV pathogenesis and management. Daily medication and indefinite antiretroviral therapy is recommended for children infected with HIV. Maintenance of life-long adherence is difficult and the incidence of triple-class virological failure after initiation of antiretroviral therapy increases with time. This challenge shows the urgent need to define novel strategies to provide long-term viral suppression that will allow safe interruption of antiretroviral therapy without viral rebound and any associated complications. HIV-infected babies treated within a few days of birth have a unique combination of a very small pool of integrated viruses, a very high proportion of relatively HIV resistant naive T cells, and an unparalleled capacity to regenerate an immune repertoire. These features make this group the optimum model population to investigate the potential efficacy of immune-based therapies. If successful, these investigations could change the way we manage HIV infection.