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Host factors and early treatments to restrict paediatric HIV infection and early disease progression

A body of evidence indicates that a threshold level of the virus is required to establish systemic and persistent HIV infection in the host and that this level depends on virus–host interactions. Mother-to-child transmission (MTCT) of HIV is the main source of paediatric HIV infection and occurs whe...

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Autores principales: Gianesin, Ketty, Petrara, Raffaella, Freguja, Riccardo, Zanchetta, Marisa, Giaquinto, Carlo, De Rossi, Anita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mediscript Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946731/
https://www.ncbi.nlm.nih.gov/pubmed/27482405
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author Gianesin, Ketty
Petrara, Raffaella
Freguja, Riccardo
Zanchetta, Marisa
Giaquinto, Carlo
De Rossi, Anita
author_facet Gianesin, Ketty
Petrara, Raffaella
Freguja, Riccardo
Zanchetta, Marisa
Giaquinto, Carlo
De Rossi, Anita
author_sort Gianesin, Ketty
collection PubMed
description A body of evidence indicates that a threshold level of the virus is required to establish systemic and persistent HIV infection in the host and that this level depends on virus–host interactions. Mother-to-child transmission (MTCT) of HIV is the main source of paediatric HIV infection and occurs when the host's immune system is still developing. Thus, innate resistance and immunity, rather than adaptive immune response, may be the main drivers in restricting the establishment of HIV reservoirs and the long-lived persistence of HIV infection in infants. Genetic variations in HIV co-receptors and their ligands, as well as in Toll-like receptors and defensins, key elements of innate immunity, have been demonstrated to influence the risk of perinatal HIV infection and disease progression in HIV-infected infants. Early treatments with combined antiretroviral therapy (cART) restrict paediatric infection by reducing the level of the transmitted/infecting virus to below the threshold required for the onset of immune response to the virus and also significantly reduce HIV reservoirs. However, despite long periods with no signs and symptoms of HIV infection, all early cART-treated children who later discontinued cART had a rebound of HIV, except for one case in whom a period of viral remission occurred. Which parameters predict viral remission or viral rebound after cART discontinuation? Could early cART prevent rather than just reduce the establishment of viral reservoirs? And, if so, how? Answers to these questions are also important in order to optimise the use of early cART in infants at high risk of HIV infection.
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spelling pubmed-49467312016-08-01 Host factors and early treatments to restrict paediatric HIV infection and early disease progression Gianesin, Ketty Petrara, Raffaella Freguja, Riccardo Zanchetta, Marisa Giaquinto, Carlo De Rossi, Anita J Virus Erad Reviews A body of evidence indicates that a threshold level of the virus is required to establish systemic and persistent HIV infection in the host and that this level depends on virus–host interactions. Mother-to-child transmission (MTCT) of HIV is the main source of paediatric HIV infection and occurs when the host's immune system is still developing. Thus, innate resistance and immunity, rather than adaptive immune response, may be the main drivers in restricting the establishment of HIV reservoirs and the long-lived persistence of HIV infection in infants. Genetic variations in HIV co-receptors and their ligands, as well as in Toll-like receptors and defensins, key elements of innate immunity, have been demonstrated to influence the risk of perinatal HIV infection and disease progression in HIV-infected infants. Early treatments with combined antiretroviral therapy (cART) restrict paediatric infection by reducing the level of the transmitted/infecting virus to below the threshold required for the onset of immune response to the virus and also significantly reduce HIV reservoirs. However, despite long periods with no signs and symptoms of HIV infection, all early cART-treated children who later discontinued cART had a rebound of HIV, except for one case in whom a period of viral remission occurred. Which parameters predict viral remission or viral rebound after cART discontinuation? Could early cART prevent rather than just reduce the establishment of viral reservoirs? And, if so, how? Answers to these questions are also important in order to optimise the use of early cART in infants at high risk of HIV infection. Mediscript Ltd 2015-07-01 /pmc/articles/PMC4946731/ /pubmed/27482405 Text en © 2015 The Authors. Journal of Virus Eradication published by Mediscript Ltd http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article published under the terms of a Creative Commons License.
spellingShingle Reviews
Gianesin, Ketty
Petrara, Raffaella
Freguja, Riccardo
Zanchetta, Marisa
Giaquinto, Carlo
De Rossi, Anita
Host factors and early treatments to restrict paediatric HIV infection and early disease progression
title Host factors and early treatments to restrict paediatric HIV infection and early disease progression
title_full Host factors and early treatments to restrict paediatric HIV infection and early disease progression
title_fullStr Host factors and early treatments to restrict paediatric HIV infection and early disease progression
title_full_unstemmed Host factors and early treatments to restrict paediatric HIV infection and early disease progression
title_short Host factors and early treatments to restrict paediatric HIV infection and early disease progression
title_sort host factors and early treatments to restrict paediatric hiv infection and early disease progression
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946731/
https://www.ncbi.nlm.nih.gov/pubmed/27482405
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