艾滋病的免疫病理改变及重建研究进展

CD4＋ T cell depletion in HIV infection and immune reconstitution following antiretroviral therapy

人类免疫缺陷病毒感染对机体免疫系统可造成直接及间接损伤，从而导致免疫功能进行性受损。有效抗逆转录病毒治疗能够抑制病毒复制并恢复感染者CD4＋T细胞数量和功能。随着治疗后免疫功能的恢复，部分病人会出现免疫重建炎症综合征。多种因素与治疗后免疫重建效果有关，获得对病毒复制的长期完全抑制，但免疫细胞数量未见显著增长的现象称为免疫重建障碍，持续异常激活与此现象的发生相关。应用免疫抑制剂或调节剂来降低异常免疫激活水平成为研究方向。

The hallmarks of HIV infection include progressive CIM~ T cell depletion and chronic immune activation. Effective antiretroviral therapy （ART） can restore CIM ~T cell counts and related immune responses to various opportunistic pathogens. On some occasions, improvement in the immune system leads to immune reconstitution inflammatory syndrome shortly after ART initiation. On the other hand, some patients fail to achieve a normal CIM ~ T cell count despite long-term suppressive ART. Multiple studies have demonstrated that persistent immune activation and inflammation are closely associated with suboptimal immune recovery although the underlining mechanisms remain widely debated.