艾滋病是由人类免疫缺陷病毒(Human immunodeficiency virus,HIV)引起的人类最严重的单一病因疾病,以全身免疫系统严重损害为特征。高效抗逆转录病毒疗法(Highly active anti-retroviral therapy,HAART)的应用已经成功地将艾滋病从一种...艾滋病是由人类免疫缺陷病毒(Human immunodeficiency virus,HIV)引起的人类最严重的单一病因疾病,以全身免疫系统严重损害为特征。高效抗逆转录病毒疗法(Highly active anti-retroviral therapy,HAART)的应用已经成功地将艾滋病从一种致死性疾病转变为慢性可控性疾病。但长期接受HAART治疗的艾滋病患者一旦停药,患者体内潜伏的HIV会迅速反弹。艾滋病无法彻底治愈的原因是患者体内HIV病毒潜伏储存库的存在。"Shock and kill"策略是使用HIV潜伏感染激活剂(Latency-reversing agents,LRAs)诱导潜伏HIV前病毒复制及表达,然后联合HAART将病毒一网打尽,同时由于细胞病变效应和/或HIV特征性免疫反应使潜伏细胞的半衰期大大缩短,最终达到功能性治愈的目的。因此,高效、安全且特异性促进潜伏库衰减的LRAs成为现今艾滋病治愈研究的热点。本文聚焦国内外前沿研究,对具有临床发展前景的HIV潜伏感染激活剂做一综述,为未来LRAs药物的研发指明方向。展开更多
Introduction. High risk human papillomaviruses (HPV) have emerged as risk factors for anal carcinoma particularly in HIV-infected patients who demonstrate a high rate of anal HPV infection. Considering the relationshi...Introduction. High risk human papillomaviruses (HPV) have emerged as risk factors for anal carcinoma particularly in HIV-infected patients who demonstrate a high rate of anal HPV infection. Considering the relationship between the presence of anal infection and the development of neoplastic lesions, we wished to assess the capacity of imiquimod to eradicate latent HPV infection in HIV-infected patients. Patients and methods. We conducted a prospective, randomized, double-blind and vehicle controlled study. Two consecutive anal swabs were taken at 2 month intervals and only patients with two consecutive tests positive for the detection of HPV-DNA (Hybrid Capture II.) were included. Patients with persistent latent HPV infection were divided into 2 groups who applied imiquimod versus vehicle during 6 weeks. HPV-DNA presence was then investigated 2 and 4 months following the onset of treatment. Results. Among the 80 HIV-infected patients, 26 (32.5 p. 100) had 2 positive consecutive assays, and 19 patients were included in the study. After randomization, 9 patients received imiquimod and 10 vehicle. There was no significant difference between treatment groups according to the following criteria: gender, route of HIV transmission, CDC stage, prior medical history of sexually transmitted diseases or anogenital warts. 33.3 p. 100 (3/9) of patients treated with imiquimod were negative at M2, whereas 100 p. 100 (10/10) vehicle treated-patients remained positive (p=0.08). Similar results were observed at the M4 visit. Discussion. Our study confirmed the increased prevalence of latent HPV-DNA infection in HIV-infected patients. In spite of the low number of treated patients, we did not observe a statistically significant decrease in HPV-DNA in anal swabs from france imquimod-treated patients as compared to placebo-treated patients.展开更多
文摘艾滋病是由人类免疫缺陷病毒(Human immunodeficiency virus,HIV)引起的人类最严重的单一病因疾病,以全身免疫系统严重损害为特征。高效抗逆转录病毒疗法(Highly active anti-retroviral therapy,HAART)的应用已经成功地将艾滋病从一种致死性疾病转变为慢性可控性疾病。但长期接受HAART治疗的艾滋病患者一旦停药,患者体内潜伏的HIV会迅速反弹。艾滋病无法彻底治愈的原因是患者体内HIV病毒潜伏储存库的存在。"Shock and kill"策略是使用HIV潜伏感染激活剂(Latency-reversing agents,LRAs)诱导潜伏HIV前病毒复制及表达,然后联合HAART将病毒一网打尽,同时由于细胞病变效应和/或HIV特征性免疫反应使潜伏细胞的半衰期大大缩短,最终达到功能性治愈的目的。因此,高效、安全且特异性促进潜伏库衰减的LRAs成为现今艾滋病治愈研究的热点。本文聚焦国内外前沿研究,对具有临床发展前景的HIV潜伏感染激活剂做一综述,为未来LRAs药物的研发指明方向。
文摘Introduction. High risk human papillomaviruses (HPV) have emerged as risk factors for anal carcinoma particularly in HIV-infected patients who demonstrate a high rate of anal HPV infection. Considering the relationship between the presence of anal infection and the development of neoplastic lesions, we wished to assess the capacity of imiquimod to eradicate latent HPV infection in HIV-infected patients. Patients and methods. We conducted a prospective, randomized, double-blind and vehicle controlled study. Two consecutive anal swabs were taken at 2 month intervals and only patients with two consecutive tests positive for the detection of HPV-DNA (Hybrid Capture II.) were included. Patients with persistent latent HPV infection were divided into 2 groups who applied imiquimod versus vehicle during 6 weeks. HPV-DNA presence was then investigated 2 and 4 months following the onset of treatment. Results. Among the 80 HIV-infected patients, 26 (32.5 p. 100) had 2 positive consecutive assays, and 19 patients were included in the study. After randomization, 9 patients received imiquimod and 10 vehicle. There was no significant difference between treatment groups according to the following criteria: gender, route of HIV transmission, CDC stage, prior medical history of sexually transmitted diseases or anogenital warts. 33.3 p. 100 (3/9) of patients treated with imiquimod were negative at M2, whereas 100 p. 100 (10/10) vehicle treated-patients remained positive (p=0.08). Similar results were observed at the M4 visit. Discussion. Our study confirmed the increased prevalence of latent HPV-DNA infection in HIV-infected patients. In spite of the low number of treated patients, we did not observe a statistically significant decrease in HPV-DNA in anal swabs from france imquimod-treated patients as compared to placebo-treated patients.
