Abstract:
Acquired immunodeficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), has become a heavy burden of disease and an important public health problem in the world. Although current antiretroviral therapy (ART) is effective at suppressing the virus in the blood, HIV still remains in two different types of reservoirs-the latently infected cells (represented by CD4+ T cells) and the tissues containing those cells, which may block access to ART, HIV-neutralizing antibodies and latency-reversing agents. The latter is the focus of our review, as blood viral load drops below detectable levels after ART, a deeper and more systematic understanding of the HIV tissue reservoirs is imperative. In this review, we take the lymphoid system (including lymph nodes, gut-associated lymphoid tissue, spleen and bone marrow), nervous system, respiratory system, reproductive system (divided into male and female), urinary system as the order, focusing on the particularity and importance of each tissue in HIV infection, the infection target cell types of each tissue, the specific infection situation of each tissue quantified by HIV DNA or HIV RNA and the evidence of compartmentalization and pharmacokinetics. In summary, we found that the present state of HIV in different tissues has both similarities and differences. In the future, the therapeutic principle we need to follow is to respect the discrepancy on the basis of grasping the commonality. The measures taken to completely eliminate the virus in the whole body cannot be generalized. It is necessary to formulate personalized treatment strategies according to the different characteristics of the HIV in the various tissues, so as to realize the prospect of curing AIDS as soon as possible.
摘要:
获得性免疫缺陷综合症(艾滋病),由人类免疫缺陷病毒(HIV)引起,已成为世界范围内沉重的疾病负担和重要的公共卫生问题。尽管目前的抗逆转录病毒疗法(ART)可有效抑制血液中的病毒,HIV仍然保留在两种不同类型的储库中-潜伏感染的细胞(以CD4T细胞为代表)和包含这些细胞的组织,这可能会阻止对ART的访问,HIV中和抗体和潜伏期逆转剂。后者是我们检讨的重点,随着血液病毒载量在ART后下降到可检测水平以下,对HIV组织储库有更深入和更系统的了解是必要的。在这次审查中,我们采取淋巴系统(包括淋巴结,肠道相关淋巴组织,脾和骨髓),神经系统,呼吸系统,生殖系统(分为男性和女性),泌尿系统作为顺序,关注HIV感染中每个组织的特殊性和重要性,每个组织的感染目标细胞类型,通过HIVDNA或HIVRNA定量的每种组织的特定感染情况以及区室化和药代动力学的证据。总之,我们发现HIV在不同组织中的现状既有相似性,也有差异性。在未来,我们需要遵循的治疗原则是在把握共性的基础上尊重差异。为完全消除全身病毒而采取的措施不能一概而论。有必要根据HIV在各个组织中的不同特点制定个性化的治疗策略,从而尽快实现治疗艾滋病的前景。