Immunologic and virologic evolution during periods of intermittent and persistent low-level viremia.

摘要: Background: HIV replication, HIV-specific T-cell responses and activation each contributes to disease outcome during untreated infection. The interaction of these factors is not well understood, particularly in the setting antiretroviral therapy. Methods: This a longitudinal study antiretroviral-treated patients with plasma RNA levels , 1000 copies/ml. Patients were divided into three groups: suppressed viremia, intermittent viremia (‘blips’) persistent low-level viremia. HIVspecific immunity was measured using interferon-a ELISPOT. defined by CD38 HLA-DR co-expression. Drug resistance quantified phenotypic susceptibility assay. Results: breadth magnitude CD8 response greater either or compared In contrast, significantly elevated only those had moderate drug that increased over time. Virologic failure (confirmed increase viral load . copies/ml) primarily observed persistently viremic group. Conclusions: Antiretroviral-treated individuals appear mount an effective while experiencing increases level immune activation. may limit evolution emergence resistance. exhibit significant overall substantial risk subsequent treatment failure. It likely higher stronger act synergistically accelerate development systemic