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Early antiretroviral therapy limits SIV reservoir establishment to delay or prevent post-treatment viral rebound.
Nature Medicine ( IF 82.9 ) Pub Date : 2018-Sep-01 , DOI: 10.1038/s41591-018-0130-7
Afam A. Okoye , Scott G. Hansen , Mukta Vaidya , Yoshinori Fukazawa , Haesun Park , Derick M. Duell , Richard Lum , Colette M. Hughes , Abigail B. Ventura , Emily Ainslie , Julia C. Ford , David Morrow , Roxanne M. Gilbride , Alfred W. Legasse , Joseph Hesselgesser , Romas Geleziunas , Yuan Li , Kelli Oswald , Rebecca Shoemaker , Randy Fast , William J. Bosche , Bhavesh R. Borate , Paul T. Edlefsen , Michael K. Axthelm , Louis J. Picker , Jeffrey D. Lifson

Prophylactic vaccination of rhesus macaques with rhesus cytomegalovirus (RhCMV) vectors expressing simian immunodeficiency virus (SIV) antigens (RhCMV/SIV) elicits immune responses that stringently control highly pathogenic SIV infection, with subsequent apparent clearance of the infection, in ~50% of vaccinees. In contrast, here, we show that therapeutic RhCMV/SIV vaccination of rhesus macaques previously infected with SIV and given continuous combination antiretroviral therapy (cART) beginning 4-9 d post-SIV infection does not mediate measurable SIV reservoir clearance during over 600 d of follow-up on cART relative to RhCMV/control vaccination. However, none of the six animals started on cART on day four or five, across both RhCMV/SIV- and RhCMV/control-vaccinated groups, those rhesus macaques with SIV reservoirs most closely resembling those of prophylactically RhCMV/SIV-vaccinated and protected animals early in their course, showed post-cART viral rebound with up to nine months of follow-up. Moreover, at necropsy, these rhesus macaques showed little to no evidence of replication-competent SIV. These results suggest that the early SIV reservoir is limited in durability and that effective blockade of viral replication and spread in this critical time window by either pharmacologic or immunologic suppression may result in reduction, and potentially loss, of rebound-competent virus over a period of ~two years.

中文翻译:

早期抗逆转录病毒疗法限制了SIV储库的建立,从而延迟或防止了治疗后病毒反弹。

表达猿猴免疫缺陷病毒(SIV)抗原(RhCMV / SIV)的恒河猴巨细胞病毒(RhCMV)载体对恒河猴进行预防性疫苗接种可引发严格控制高致病性SIV感染的免疫反应,随后在约50%的疫苗中明显清除了感染。相反,在这里,我们显示先前感染SIV并在SIV感染后4-9 d开始给予连续联合抗逆转录病毒疗法(cART)的猕猴的RhCMV / SIV疫苗接种不会在600 d内介导可测量的SIV储库清除率有关RhCMV /对照疫苗接种的cART随访。但是,在RhCMV / SIV和RhCMV /对照接种组中,六只动物均没有在第4天或第5天开始使用cART,那些具有SIV储库的恒河猴,在其病程的早期与预防性RhCMV / SIV疫苗接种和受保护的动物最相似,显示了cART后病毒反弹,并进行了长达9个月的随访。此外,在尸检时,这些恒河猕猴几乎没有或没有证据显示具有复制能力的SIV。这些结果表明,早期SIV储库的耐用性受到限制,并且在此关键时间窗内通过药理或免疫学抑制作用有效阻断病毒复制和传播可能会导致反弹型病毒在一段时间内减少并可能丢失。 〜两年。这些恒河猴显示出几乎没有复制能力的SIV证据。这些结果表明,早期SIV储库的耐用性受到限制,并且在此关键时间窗内通过药理或免疫学抑制作用有效阻断病毒复制和传播可能会导致反弹型病毒在一段时间内减少并可能丢失。 〜两年。这些恒河猴显示出几乎没有复制能力的SIV证据。这些结果表明,早期SIV储库的耐用性受到限制,并且在此关键时间窗内通过药理或免疫学抑制作用有效阻断病毒复制和传播可能会导致反弹型病毒在一段时间内减少并可能丢失。 〜两年。
更新日期:2018-08-06
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