摘要
高效抗逆转录病毒治疗(HAART)治疗可以显著降低HIV/AIDS患者的病毒复制,提高CD4+T淋巴细胞的数量,重建患者免疫功能。但仍有部分患者在病毒抑制的情况下不能取得良好的免疫重建,发生免疫重建不良现象。近年来,免疫重建不良现象已成为临床研究热点之一。本文从概念、判定标准、发病机制、临床表现和可能的干预措施等方面对HIV/AIDS患者免疫重建不良现象进行了综述。综合文献资料认为,免疫重建不良的发生机制主要涉及骨髓造血功能降低和胸腺输出减少造成的CD4+T细胞产生减少、免疫活化和凋亡增加造成的CD4+T细胞破坏增多及体内IL-7等细胞因子水平紊乱等。目前对免疫重建不良尚未有成熟有效的干预措施,及早开始HAART治疗是预防免疫重建不良的关键,其余各种干预措施也在一定程度上改善了HIV/AIDS患者的免疫重建状态。然而,免疫重建不良的机制尚未完全清楚,目前尚未找到行之有效的解决方法,在攻克艾滋病的道路上,免疫重建不良仍然是一个重要的研究领域。
HAART could reduce the viral load to undetectable level and at the same time restore CD4＋T cells to rebuild immune function of HIV/AIDS patients. However, such immune reconstitution had its limitation. It had been reported that despite fully HIV-1 replication suppression, part of HIV/AIDS patients failed to acquire ideal immune-reconstitution. The phenomenon of immune-reconstitution failure has drawn great attention in the past decade. The deifnition, criterion, pathogenesis, clinical manifestations and intervention measures of HIV/AIDS patients with immune-reconstruction failure were summarized. It had been reported that the pathogenesis of immune-reconstruction failure mainly involved reduced CD4^＋T cell generation caused by impaired bone marrow hematopoietic function and thymic output, increased CD4＋T cell destruction caused by immune activation, apoptosis and cytokine disorder and so on. There had not been mature intervention measures till now, early HAART was the key of prevention of immune-reconstitution failure. Despite intensive researches, the pathogenesis and solution of this phenomenon was not yet clear. Immune-reconstitution failure was still an important area of study on the way to conquer AIDS.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2015年第4期25-30,共6页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
国家自然科学基金项目(No.81371804)
首都卫生发展科研专项项目(No.2014-2-2173)
关键词
高效抗逆转录病毒治疗
艾滋病
人类免疫缺陷病毒
免疫重建
Highly active antiretroviral therapy
Acquired immune deficiency syndrome
Human immunodeficiency virus
Immune reconstitution
