艾滋病患者肠道微生态与抗逆转录病毒治疗及耐药相关性研究新进展

Recent advances in research on correlation between intestinal microecology and antiretroviral therapy and drug resistance in AIDS patients

艾滋病(AIDS)是一种由人类免疫缺陷病毒(HIV)引起的免疫缺陷性疾病,因其高传染性和不可治愈而备受关注。本文综述了HIV患者肠道菌群的变化与其发病机制、抗逆转录病毒耐药及肠道免疫激活的相关性。抗逆转录病毒治疗(ART)是降低肠道黏膜免疫和导致持续炎症的独立风险因素。肠道菌群参与或干扰抗病毒药物的代谢,造成肠道黏膜的通透性增加,微生物移位,激活不同的T细胞亚群的免疫活性,产生炎性因子导致CD4^(+)细胞数量持续低下。某些特定的益生菌及粪菌移植(FMT)可调节HIV患者的肠道微生态的平衡,延缓AIDS的发病进程。

AIDS is an immunodeficiency disease caused by human immunodeficiency virus(HIV).This review reports the correlation between intestinal flora and antiretroviral drug resistance,pathogenesis and intestinal immune activation in HIV patients.Antiretroviral therapy(ART)is an independent risk factor to decrease intestinal mucosal immunity and result in continuing inflammation.Intestinal flora participates in or interferes with the metabolism of antiviral drugs.Then the intestinal mucosal permeability increased,microbial site translocated,and the immune activity of different T cell subsets activated.Bacterial decomposition stimulates the body to produce inflammatory factors and lead to continuous low CD4^(+)cell number.Certain probiotics and faecal bacteria transplantation(FMT)can regulate the balance of intestinal microecology in HIV patients and delay the development of AIDS.