高效抗病毒治疗促使艾滋病患者免疫功能重建

艾滋病的特征是ＨＩＶ 1感染人体后 ,造成ＣＤ4 +Ｔ淋巴细胞数量进行性减少、细胞免疫功能损害 ,最后导致艾滋病 (ＡＩＤＳ)。先前的研究表明这种免疫功能的丧失是不可逆转的 ,抗ＨＩＶ病毒治疗仅能控制或减缓其进展。近年来 ,由于强效联合抗病毒治疗 (ＨＡＡＲＴ)的应用 ,艾滋病的发病率和死亡率均较前明显下降 (指西方国家 )。说明ＨＡＡＲＴ不仅能有效的控制ＨＩＶ 1的复制 ,并能使艾滋病病人的免疫功能得到恢复。这种ＨＡＡＲＴ使艾滋病病人免疫功能重建的假说最近被一组法国研究人员证实 ,艾滋病的免疫重建规律是 :(1)治疗早期ＣＤ4 +…

Immune reconstitution in AIDS patients during highly active antiretroviral therapires

The characteristics of AIDS is that HIV infection induces CD4　+ T cell defects that includes a quantitave CD4　+ T cells depletion and a loss of T helper cells function leading to a progressive immune deficiency. Early report indicated that this immune deficiency was irreversible, even with the antiretroviral therapies. More recently, however, clinical benifits of hightly active antiretroviral therapies (HAART) are increasingly evidenced by resolving opportunistic infections and malignancies, as well as declining hospitalization and mortality rates. This suggests that potent and sustained suppression of viral replication, at least to some extent, is associated with reconstitution of the immune system even in adult patients treated at advanced stages of the disease. Such immune reconstitution which was demonstrated firstly by a French reseach group includes (the group leader is Pr Brigitte Autran)(1) a rapid rise in CD4　+ and CD8+ T cells followed by a slower CD4　+ T cell increase; (2) a rapid rise in memory CD4　+ T cells during the first three months of treatment by late increase in naive T cells coexpressing CD45RA and CD62L molecules after 3 months of efficient antiviral treatment;(3) a significant reduction of CD4 and CD8 activation markers in parallel to plasma virus load reduction;(4) a restoration in CD4　+ T cell reactivity to recall antigens. These observations open new perspectives for the understanding of CD4　+ T cells deficiency and therapeutic strategies of HIV infection. In the present review we will address some of the questions raised by immune restoration with HAART when administered at advanced stages of the disease.