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Recuperación del VIH capaz de replicarse a pesar de la supresión prolongada de la viremia plasmática
J K Wong1, M Hezareh, H F Günthard
1Department of Medicine, University of California, San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Science (New York, N.Y.)
|November 21, 1997
Resumen
Incluso con un tratamiento eficaz contra el VIH, el virus latente se puede aislar de los pacientes. Este estudio encontró el virus activo en las células a pesar del ARN del VIH no detectable en el plasma, lo que indica que persisten los depósitos virales.
Área de la Ciencia:
- Virología Virología.
- Inmunología Inmunología.
- Enfermedades infecciosas Enfermedades infecciosas.
Sus antecedentes:
- Los regímenes de medicamentos de combinación actuales del virus de la inmunodeficiencia humana (VIH) tienen como objetivo la supresión viral.
- Comprender los reservorios virales persistentes es crucial para erradicar el VIH.
- Los reservorios latentes del VIH pueden evadir las estrategias terapéuticas actuales.
Objetivo del estudio:
- Para investigar la presencia de reservorios latentes de VIH en pacientes sometidos a terapia de fármacos combinados.
- Para determinar si la reactivación viral puede ocurrir a pesar de la supresión a largo plazo del ARN del VIH en el plasma.
Principales métodos:
- Las células mononucleares de la sangre periférica (PBMC) se recolectaron de pacientes con VIH y donantes normales.
- Las células CD8 se agotaron de los PBMC.
- Los linfocitos CD4 del paciente se activaron utilizando anticuerpos inmovilizados contra CD3 y CD28.
- Se realizó el aislamiento del virus de los PBMC.
- Se llevó a cabo la secuenciación parcial del pológeno del VIH.
Principales resultados:
- El VIH se aisló con éxito de los PBMC de seis pacientes con ARN del VIH plasmático por debajo de 50 copias / ml durante un máximo de 2 años.
- La secuenciación parcial del polgen del VIH no reveló nuevas mutaciones de resistencia a los fármacos.
- No se observó ninguna evolución viral discernible en los fragmentos de pol genes secuenciados.
Conclusiones:
- Los hallazgos proporcionan evidencia de la existencia de reservas persistentes y latentes de VIH.
- La latencia viral, más que el fracaso del fármaco, explica el aislamiento del virus de los PBMC.
- Estos reservorios latentes representan un desafío para la erradicación completa del VIH.
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