美国国立卫生研究院Tae-Wook Chun团队取得最新进展。他们揭示两个人类免疫缺陷病毒 (HIV)感染者中断抗逆转录病毒疗法 (ART)治疗后长期病毒学控制的不同机制。这一研究成果于2021年10月28日发表在国际顶尖学术期刊《自然—医学》上。

他们介绍了两个对比鲜明的HIV感染者在接受分析性治疗中断 (ATI) 后长时间控制血浆病毒血症的病例报告。在第 1,250 天前不久，04号参与者，经历了病毒突变并开始未公开自我管理检测到的次优ART ，血浆HIV env序列的系统发育分析表明，随着时间的推移，病毒持续进化和/或预先存在的病毒库重新激活。04号参与者的抗病毒 CD8+ T 细胞活性高于30号参与者。

相比之下，30号参与者表现出有效的血浆IgG介导的针对自体病毒的中和活性，在ATI后 1,434 天，他因 HIV重复感染而经历突然的血浆病毒反弹时变得无效。他们的数据提供了对治疗后中断控制的不同机制的深入了解，并强调了在ATI阶段频繁监测未公开的ART使用和重复感染的重要性。

据介绍，在没有ART的情况下，某些受感染的个体会抑制HIV。人们对阐明潜在的机制具有很高的兴趣。

附：英文原文

Title: Distinct mechanisms of long-term virologic control in two HIV-infected individuals after treatment interruption of anti-retroviral therapy

Author: Blazkova, Jana, Gao, Feng, Marichannegowda, Manukumar Honnayakanahalli, Justement, J. Shawn, Shi, Victoria, Whitehead, Emily J., Schneck, Rachel F., Huiting, Erin D., Gittens, Kathleen, Cottrell, Mackenzie, Benko, Erika, Kovacs, Colin, Lack, Justin, Sneller, Michael C., Moir, Susan, Fauci, Anthony S., Chun, Tae-Wook

Issue&Volume: 2021-10-28

Abstract: Certain infected individuals suppress human immunodeficiency virus (HIV) in the absence of anti-retroviral therapy (ART). Elucidating the underlying mechanism(s) is of high interest. Here we present two contrasting case reports of HIV-infected individuals who controlled plasma viremia for extended periods after undergoing analytical treatment interruption (ATI). In Participant 04, who experienced viral blips and initiated undisclosed self-administration of suboptimal ART detected shortly before day 1,250, phylogenetic analyses of plasma HIV env sequences suggested continuous viral evolution and/or reactivation of pre-existing viral reservoirs over time. Antiviral CD8+ T cell activities were higher in Participant 04 than in Participant 30. In contrast, Participant 30 exhibited potent plasma-IgG-mediated neutralization activity against autologous virus that became ineffective when he experienced sudden plasma viral rebound 1,434 d after ATI due to HIV superinfection. Our data provide insight into distinct mechanisms of post-treatment interruption control and highlight the importance of frequent monitoring of undisclosed use of ART and superinfection during the ATI phase. CD8 T cell activity or neutralizing antibodies might control HIV-1 viral rebound after cessation of anti-retroviral therapy.

DOI: 10.1038/s41591-021-01503-6

Source: https://www.nature.com/articles/s41591-021-01503-6