艾滋病功能性治愈策略研究进展

Progress on functional cure for AIDS

高效抗逆转录病毒治疗(highly active anti-retroviral therapy,HAART)的广泛应用,显著延长了人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者的寿命,使艾滋病(acquired immune deficiency syndrome,AIDS)由一种致死性疾病转变为可控的慢性疾病。但是,由于病毒潜伏库及病毒库在HIV感染后快速形成、持续存在且难以清除,因此现有治疗策略无法实现AIDS的彻底治愈。目前,已经成功提出功能性治愈的概念,即通过改善现有的治疗策略实现长期抑制HIV复制,维持CD4+T细胞数量和机体免疫功能正常,尤其是在停药后能够长期控制病毒复制。因此,功能性治愈的成功实施可有效改善患者机体免疫功能紊乱,减轻长期应用HAART方案引起的严重的药物毒副作用及不良反应,有效提高患者的生活质量。现就AIDS功能性治愈的相关策略,包括HAART的早期治疗、激活并杀灭策略、基因治疗、免疫治疗和永久沉默等作一概述。

The widely used application of HAART（ highly active antiretroviral therapy） significantly prolongs the lifespan of patients suffered from AIDS（ acquired immune deficiency syndrome）,by which AIDS from a fatal disease has been transformed into a chronic infectious disease. But latent HIV reservoir and viral reservoirs can rapidly develop and consistent presence,and it is difficult to eradicate. Since the currently therapeutic strategies do not obtain sterilizing cure for AIDS,as a result,the functional cure has been developed,which refers to the long-term control of HIV replication,and to maintain a normal level and immune function of CD4＋T cell. More importantly,this therapy can control viral replication when discontinuing the therapeutic regiments. So,functional cure can alleviate the serious side effect of long-term medication and improve quality of the patients＇ life. This review focuses on the recent progress of strategies on achieving functional cure for AIDS,including early treatment of HAART,shock and kill,gene therapy,immunotherapy and permanent silencing.