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JID：抗逆转录病毒治疗联合拉替拉韦可介导HIV-1感染者快速免疫重建

2013-09-16 潘风雨无阻 DXY

HIV-1感染拉替拉韦抗逆转录病毒
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已有研究发现，未经治疗的HIV慢性感染患者接受抗逆转录病毒治疗（cART）联合拉替拉韦（RAL）时，体内的CD4+T细胞数量快速回升。RAL是一种新型的抗逆转录病毒药物，能够抑制HIV-1整合酶的活性，并在2009年就获得美国食品及药物管理局批准用于HIV-1感染初治患者。在未经治疗的慢性HIV感染者中，超过10天的多剂量RAL单一疗法在控制病毒上优于安慰剂组。当同时注射核苷酸骨架时，RAL能迅速

已有研究发现，未经治疗的HIV慢性感染患者接受抗逆转录病毒治疗（cART）联合拉替拉韦（RAL）时，体内的CD4+T细胞数量快速回升。RAL是一种新型的抗逆转录病毒药物，能够抑制HIV-1整合酶的活性，并在2009年就获得美国食品及药物管理局批准用于HIV-1感染初治患者。在未经治疗的慢性HIV感染者中，超过10天的多剂量RAL单一疗法在控制病毒上优于安慰剂组。当同时注射核苷酸骨架时，RAL能迅速抑制HIV的复制，并在4周内将HIV RNA控制在每毫升50拷贝数以下。

慢性HIV感染以CD4+T细胞的消耗和cART稳定抑制病毒后仍持续存在的免疫活化为特点。在这种情况下，免疫活化与免疫重建呈负相关，且免疫活化归因于肠道微生物易位；血浆中的可溶CD14水平升高，并且能独立预测cART治疗的HIV感染者的死亡率。为了探究RAL在一线治疗中对定量和定性的免疫重建以及对免疫活化的影响，来自美国迈阿密米勒医科大学医学部的Suresh Pallikkuth和同事展开了一项研究，研究结果在线发表于2013年8月6日的Journal of Infectious Diseases上。研究发现，联合ART和拉替拉韦可介导快速免疫重建。【原文下载】

研究者开展了为期48周的亚组研究，共涉及15名患者，平均年龄为40岁，未经治疗的慢性HIV感染者接受2个阶段的cART-RAL随机化试验。

结果显示，在15名患者中，有13名在第4周时的血浆病毒负荷从5.2 ± 5.3 log10HIV RNA copies/mL降到了2.2 ± 2.4 log10 copies/mL，第8周时的值低于50 copies/mL。总的CD4+T细胞在第4周有所下降，中枢记忆CD4+T细胞数也下降，这与CD4、CD8T细胞中免疫活化标志HLA-DR、CD38和免疫消耗标志PD1的减少有关。未成熟CD4+T细胞在第24周时有所升高，28周时在CD4和CD8T细胞内出现HIV-gap特异性的IL-12、IFN-γ和CD107a反应。与健康者相比，HIV患者的血浆脂多糖和可溶CD4有所下降，但在第48周升高。总之，接受RAL-cART治疗的患者48周后的免疫状态比未接受RAL-cART治疗的患者更加良好。

研究发现，HIV一线治疗方案中的RAL介导快速免疫重建和低水平的局部微生物易位。

原文下载

Pallikkuth S, Fischl MA, Pahwa S.Combination Antiretroviral Therapy With Raltegravir Leads to Rapid Immunologic Reconstitution in Treatment-Naive Patients With Chronic HIV Infection.J Infect Dis. 2013 Aug 23

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    2014-07-05 mjldent

    #转录#

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    2013-12-07 hxj0117

    #逆转录#

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    2013-12-02 xiaogang317

    #逆转录病毒#

    0

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    2014-05-20 一叶知秋

    #抗逆转录病毒#

    0

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    2014-02-17 紫砂壶

    #JID#

    0

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    2013-09-18 crystal0567

    #抗逆转录病毒治疗#

    0