Novel therapies/hopes for HIV cure in perinatally acquired HIV-positive adolescents

被引:0
|
作者
Pasvol, Thomas Joshua [1 ]
Foster, Caroline [2 ]
Fidler, Sarah [1 ]
机构
[1] Imperial Coll London, 16 Crescent, London E17 8AB, England
[2] Imperial Coll Healthcare NHS Trust, London, England
关键词
HIV remission; perinatal HIV infection; post-treatment control; EARLY ANTIRETROVIRAL THERAPY; TREATMENT INTERRUPTION; VIRAL RESERVOIR; HIV-1-INFECTED CHILDREN; INFECTED INDIVIDUALS; VIROLOGICAL CONTROL; SEXUAL ATTITUDES; NATIONAL SURVEYS; LIFE-STYLES; SIZE;
D O I
10.1097/COH.0000000000000455
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Purpose of reviewSuccessful roll-out of paediatric antiretroviral therapy (ART) has led to a significant increase in survival of adolescents and young people growing up with HIV. Those on suppressive ART since childhood represent a unique group particularly well positioned to interrupt ART and achieve post-treatment control (PTC), or HIV remission. This maybe a consequence of early and sustained treatment since infancy, the small size of the HIV reservoir, the presence of a functioning thymus and a more flexible' immune system better able to respond to novel immune therapeutic interventions when compared with adults who acquired HIV at a time of immunological maturity and thymic involution.Recent findingsIn the past year, there have been additional case reports of post-treatment viral control amongst perinatally acquired HIV adolescents and young adults (PaHIV-AYA). In this article, we review and compare the characteristics of PTC in PaHIV-AYA and discuss the potential implications of these observations for the growing population of adolescents living with HIV. The correlation between low levels of HIV DNA and seroreversion may provide a feasible screening tool to select candidates most suitable for future intervention studies and viral remission.ConclusionWhilst it is premature to anticipate an HIV cure, there is much anticipation that with early ART and additional interventions to perturb the residual viral reservoir, future viral remission off ART might be feasible for PaHIV-AYA. However, given the safety and effectiveness of current ART, a critical debate must evaluate the risks against benefits of any novel intervention, especially amongst adolescents as they become sexually active.
引用
收藏
页码:281 / 287
页数:7
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