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首页> 外文期刊>Proceedings of the National Academy of Sciences of the United States of America >Interruption of antiretroviral therapy to augment immune control of chronic HIV-1 infection: Risk without reward
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Interruption of antiretroviral therapy to augment immune control of chronic HIV-1 infection: Risk without reward

机译：中断抗逆转录病毒疗法以增强对慢性HIV-1感染的免疫控制：无回报的风险

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摘要

There is no doubt that continuous treatment of HIV-infected persons with combinations of three or more antiretroviral drugs reduces morbidity and mortality from HIV-1 infection. Nevertheless, growing concern about the long-term tox-icity of antiretroviral drugs, the prevalence of HIV-1 drug resistance in patients receiving therapy, and the substantial cost of continuous treatment has focused interest on postponing therapy or administering it only intermittently. Potential benefits of intermittent therapy include (ⅰ) augmentation of HIV-specific immunity through "autovaccina-tion" from recru-descent viremia that occurs during treatment interruptions; (ⅱ) lowering of drug exposure to decrease toxicity; and (ⅲ) reduction in the cost of antiretroviral therapy. Data in humans and animal models support "autovaccination" in acute HIV-1 infection (i.e., before serologic conversion), but this strategy is controversial in chronic HIV-1 infection because of limited and conflicting data. An important report in this issue of PNAS by Oxenius et al. (7) describes the disappointing results of sequential, structured treatment interruptions (STIs) on virologic and immunologic parameters in a large prospective trial of STI in chronic HIV-1 infection.
机译：毫无疑问，用三种或更多种抗逆转录病毒药物的组合持续治疗HIV感染者可降低HIV-1感染的发病率和死亡率。然而，越来越多的人担心抗逆转录病毒药物的长期毒性，接受治疗的患者中HIV-1耐药性的普遍性以及持续治疗的巨大成本，使人们对推迟治疗或仅间歇性地进行治疗感兴趣。间歇治疗的潜在好处包括：（ⅰ）通过在治疗中断期间发生的复发性病毒血症的“自动疫苗接种”来增强HIV特异性免疫力； （ⅱ）减少药物接触以降低毒性； （ⅲ）降低抗逆转录病毒疗法的费用。人类和动物模型中的数据支持急性HIV-1感染（即在血清学转换之前）的“自动疫苗接种”，但由于数据有限且相互矛盾，这种策略在慢性HIV-1感染中存在争议。 Oxenius等人在本期PNAS中发表了重要报告。 （7）描述了在一项关于慢性HIV-1感染的STI大型前瞻性试验中，对病毒学和免疫学参数进行连续，结构化治疗中断（STIs）令人失望的结果。

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