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艾滋病毒感染儿童的长期非进展:基于国际队列数据的估计

Charlotte Jackson¹, Siobhan Crichton¹, Ali Judd^1,2

¹MRC Clinical Trials Unit at UCL, University College London, UK.

AIDS (London, England)

|February 6, 2025

概括

在没有抗逆转录病毒治疗 (ART) 的情况下,在8岁时,高达10%的患有围产期艾滋病毒的儿童实现了长期不进展 (LTNP). 这一发现有助于研究治愈艾滋病毒和治疗后控制策略.

科学领域:

儿童传染病儿童传染病
艾滋病毒/艾滋病研究研究
免疫学免疫学免疫学

背景情况:

在儿童中经产期获得的艾滋病毒对长期管理提出了独特的挑战.
在没有治疗的情况下了解自然疾病进展对于识别宿主控制的潜在指标至关重要.
抗逆转录病毒疗法 (ART) 已经改变了艾滋病毒管理,但对宿主控制的非进展的研究对于治愈策略至关重要.

研究的目的:

为了估计长期非进展 (LTNP) 的概率,在没有ART的情况下患有围产期获得的HIV的儿童.
评估LTNP的不同定义如何影响这些概率估计.
为了确定患有LTNP的儿童进行治疗后控制和治愈艾滋病毒的研究.

主要方法:

来自欧洲和泰国队列至2016年的纵向例行艾滋病毒护理数据的分析.
长期不孕症被定义为达到8岁时没有疾病进展 (艾滋病诊断或世卫组织定义的免疫抑制).
在8岁之前开始ART被视为具有竞争力的风险;分析了多个队列纳入标准.

主要成果:

在2004-2007年出生在国家队伍中的儿童中,10% (95% CI:6-15%) 在使用世卫组织免疫抑制标准时,在8岁时达到LTNP.
根据队列纳入标准和出生年份,估计有所不同,早期的出生年份显示较低的LTNP率.
在不同的免疫抑制值和年龄调整后的CD4+标准中,结果一致.

结论:

在2004年至2007年间出生,患有周产期艾滋病毒的儿童中,大约10%的儿童在没有ART的情况下在8岁时获得了LTNP.
这些发现突出了艾滋病毒感染儿童的一个子集中自发长期非进展的潜力.
识别这些LTNP个体是推动艾滋病毒治愈研究和了解病毒控制机制的关键.

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