早期抗HIV病毒治疗英文ppt课件.pptVIP

Towards an HIV cure Reporter : Fang Zhao Ph.D.M.D. Definition HIV cure a sterilizing cure: the elimination of all HIV-infected cells. a functional cure: the generation of effective host immunity to HIV that would result in lifelong control of the virus in the absence of therapy, despite not achieving the complete eradication of HIV. a baby and 14 adults are functionally cured. “A Mississippi baby” born with HIV more than two years ago appears to be the first documented case of a childs being cured of the virus. * VISCONTI cohort: 14 patients who began ART within 10 weeks after the start of infection and continued for up to 3 years were more likely to control HIV replication without medications after subsequent treatment discontinuation. (PLoS Pathogens, DOI: 10.1371/journal.ppat.1003211) “Very early antiretroviral treatment” i) further reduce residual viral replication ii) accelerate immune restoration iii) preserve innate immunity and T band B cell functions iv) limit viral diversity and viral reservoirs Short-Course Antiretroviral Therapy in Primary HIV Infection The SPARTAC Trial Investigators* *(Short Pulse Anti-Retroviral Therapy at Seroconversion ) N Engl J Med 2013; 368:207-217January 17, 2013DOI: 10.1056/NEJMoa1110039 Back ground Immunologic damage after HIV acquisition occurs rapidly. a short course of ART during primary HIV infection preserve immune function, decrease viral evolution limit the viral reservoir Primary HIV infection defined Definitive Criterion: 1. a positive HIV-antibody test within 6 months after a negative test; 2. a negative HIV-antibody test with a positive reverse-transcription–polymerase-chain-reaction assay for HIV RNA Presumptive Critrion 3. a low level of HIV antibodies (optical density units [OD], 0.6) according to a serologic testing algorithm for recent infection (subtype B strain only) 4. an equivocal HIV-antibody test with a repeat test within 2 weeks showing an increase in the level of HIV antibodies 5. c