早期抗HIV病毒治疗英文课件.ppt

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1、TowardsanHIVcureReporter:FangZhaoPh.D.&M.D.DefinitionHIVcureasterilizingcure:theeliminationofallHIV-infectedcells.afunctionalcure:thegenerationofeffectivehostimmunitytoHIVthatwouldresultinlifelongcontrolofthevirusintheabsenceoftherapy,despitenotachievingthecompleteeradicationofHIV.curedfol

2、lowinganallogeneicCCR5Δ32/Δ32haematopoieticstemcelltransplanthassparkedinterestinstudyingcurativeinterventionsintheclinic“BerlinPatient”,TimothyBrownababyand14adultsare"functionallycured."“AMississippibaby”bornwithHIVmorethantwoyearsagoappearstobethefirstdocumentedcaseofachild'sbeingcuredo

3、fthevirus.*VISCONTIcohort:14patientswhobeganARTwithin10weeksafterthestartofinfectionandcontinuedforupto3yearsweremorelikelytocontrolHIVreplicationwithoutmedicationsaftersubsequenttreatmentdiscontinuation.(PLoSPathogens,DOI:10.1371/journal.ppat.1003211)“Veryearlyantiretroviraltreatment”i)fu

4、rtherreduceresidualviralreplicationii)accelerateimmunerestorationiii)preserveinnateimmunityandTbandBcellfunctionsiv)limitviraldiversityandviralreservoirsRestingmemoryCD4+TcellsmonocytesdendriticcellsmacrophageshaematopoieticstemcellsviralreservoirsShort-CourseAntiretroviralTherapyinPrimary

5、HIVInfectionTheSPARTACTrialInvestigators**(ShortPulseAnti-RetroviralTherapyatSeroconversion)NEnglJMed2013;368:207-217January17,2013DOI:10.1056/NEJMoa1110039ImmunologicdamageafterHIVacquisitionoccursrapidly.ashortcourseofARTduringprimaryHIVinfectionpreserveimmunefunction,decreaseviralevolut

6、ionlimittheviralreservoirBackgroundPrimaryHIVinfectiondefinedDefinitiveCriterion:1.apositiveHIV-antibodytestwithin6monthsafteranegativetest;2.anegativeHIV-antibodytestwithapositivereverse-transcription–polymerase-chain-reactionassayforHIVRNAPresumptiveCritrion3.alowlevelofHIVantibodies(opt

7、icaldensityunits[OD],<0.6)accordingtoaserologictestingalgorithmforrecentinfection(subtypeBstrainonly)4.anequivocalHIV-antibodytestwitharepeattestwithin2weeksshowinganincreaseinthelevelofHIVantibodies5.clinicalmanifestationsofsymptomaticHIVseroconversionillness