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2015 ; 112
(17
): 5467-72
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Post-treatment control of HIV infection
#MMPMID25870266
Conway JM
; Perelson AS
Proc Natl Acad Sci U S A
2015[Apr]; 112
(17
): 5467-72
PMID25870266
show ga
Antiretroviral therapy (ART) for HIV is not a cure. However, recent studies
suggest that ART, initiated early during primary infection, may induce
post-treatment control (PTC) of HIV infection with HIV RNA maintained at <50
copies per mL. We investigate the hypothesis that ART initiated early during
primary infection permits PTC by limiting the size of the latent reservoir,
which, if small enough at treatment termination, may allow the adaptive immune
response to prevent viral rebound (VR) and control infection. We use a
mathematical model of within host HIV dynamics to capture interactions among
target cells, productively infected cells, latently infected cells, virus, and
cytotoxic T lymphocytes (CTLs). Analysis of our model reveals a range in CTL
response strengths where a patient may show either VR or PTC, depending on the
size of the latent reservoir at treatment termination. Below this range, patients
will always rebound, whereas above this range, patients are predicted to behave
like elite controllers. Using data on latent reservoir sizes in patients treated
during primary infection, we also predict population-level VR times for
noncontrollers consistent with observations.
|*Adaptive Immunity
[MESH]
|*HIV Infections/immunology/prevention & control
[MESH]
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