慢性人免疫缺陷病毒感染者的免疫激活与免疫重建不全

Immune Activation and Incomplete Immune Reconstitution in Chronic Human Immunodeficiency Virus Infected Patients

联合抗反转录病毒治疗(combined antiretroviral therapy,c ART)问世后,人免疫缺陷病毒(human immunodeficiency virus,HIV)感染者的生活质量和预期寿命均大大提升,但仍有少部分慢性感染者在长期c ART治疗且病毒完全抑制的情况下,CD4+T细胞不能得到满意的恢复(CD4+T细胞计数<500个/μl),这些免疫重建不全感染者的机会性感染发生率、死亡率远高于免疫重建满意的感染者。免疫重建不全发生的重要机制之一是存在异常的免疫激活。针对HIV感染者免疫激活的干预研究中,体外实验和临床试验均提示雷公藤多甙可能对慢性HIV感染者免疫激活有抑制作用并对免疫重建不全者的免疫功能起到改善作用。

With the development of combined antiretroviral therapy （cAR T ）,the quality of life and life expectancy of the human immunodeficiency virus （HIV） infected adults have been significantly elevated. Howev-er ,there still remains a small amount of HIV infected adults who could not regain a satisfactory amount of CD4＋ T cells （ 〈500 cell/μl ） even with long-term cART treatment and complete viral suppression. These infected indi-viduals with incomplete immune reconstitution are more likely to acquire an opportunistic infection and have a higher mortality rate than infected individuals with complete immune reconstitution. One of the most important mechanisms behind incomplete immune reconstitution is the existence of abnormal immune activation. Among the studies of interventions on immune activation in HIV infected adults, an in vitro experiment and a clinical trial have indicated that Tripterygium wilfordii Hook F （TwHF） could suppress the abnormal immune activation,and may improve the immune reconstitution state in patients with incomplete immune reconstitution.