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高效抗逆转录病毒治疗(highly active antiretroviral treatment,HAART)在延长获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者的生存方面具有重要作用,然而随着HIV感染者寿命的延长,AIDS痴呆综合征(AIDS dementiacomplex,ADC),其他非AIDS相关疾病,心血管病(cardiovascular disease,CVD)也比较常见.这些各种疾病对脑组织中HIV-1DNA的影响在HAART后还未完全搞清楚.本文的研究目的是澄清HAART后ADC以及其他HIV感染的并发症对AIDS病人脑组织中病毒载量的影响.本实验用定量PCR研究了13例AIDS病人脑组织尸检标本,这些病人死于AIDS并发症,除1例病人外,其他12例病人均从1995年开始接受HAART治疗,直到死亡.2例死于严重的CVD,脑组织中广泛的动脉粥样硬化(cerebrovascular atherosclerosis,CVA).5例AIDS病人死于ADC,6例AIDS人既无ADC,也无CVA.用定量PCR检测了病人脑组织6个部位(脑膜、前叶灰质、前叶白质、颞叶皮层下部、小脑和基底节)HIV-1DNA的含量并对其进行了比较.HAART后,与非ADC/CVA的AIDS病人相比,ADC的AIDS病人脑组织中HIV-1DNA含量明显升高.一个新的发现是,2例患有CVD,特别是CVA的病人,脑组织中,也同样检出高浓度的HIV-1DNA,这些病人并没有ADC的症状,这是首次报道CVA与脑组织中HIV-1病毒载量有关.研究表明,HAATR抗性的HIV病毒储存库可能存在于ACD患者脑组织的损伤部位及富含巨噬细胞的动脉粥样硬化斑块中,仍需要大量的CVA病例研究来证实后者.
Highly active antiretroviral therapy (HAART) plays an important role in prolonging the survival of patients with acquired immunodeficiency syndrome (AIDS). However, with the prolonged life expectancy of HIV-infected people, AIDS dementia complex AIDS, dementiacomplex (ADC), other non-AIDS-related diseases and cardiovascular disease (CVD) are also more common.The influence of these various diseases on HIV-1 DNA in brain tissue has not been completely elucidated after HAART. The purpose of this study was to elucidate the effect of ADC and other HIV infection complications on the viral load in brain tissue of AIDS patients after HAART.This experiment used quantitative PCR to study the autopsy specimens of 13 AIDS patients who died of AIDS complications , Except 1 patient, the other 12 patients were treated with HAART until 1995. 2 died of severe CVD, extensive cerebrovascular atherosclerosis (CVA) in brain tissue, and 5 cases of AIDS The patient died of ADC, 6 AIDS patients had neither ADC nor CVA. Six sites of brain tissue (including meninges, anterior lobe, anterior lobe white matter, temporal lobe HIV-1 DNA levels in the lower layers, cerebella and basal ganglia were compared and compared, and HIV-1 DNA levels were significantly elevated in the brains of AIDS patients with ADC compared to non-ADC / CVA AIDS patients after HAART The new finding is that high concentrations of HIV-1 DNA were also detected in 2 patients with CVD, especially in CVA, and in brain tissue. These patients did not have any symptoms of ADC. This is the first report of a relationship between CVA and brain HIV -1 viral load.Studies have shown that HAATR-resistant HIV viral repositories may be present in brain tissue lesions and atherosclerotic plaque rich in macrophages in ACD patients, and large CVA case studies are still needed To confirm the latter.