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A cura funcional da infeção por HIV: “Elite Controllers” e os mecanismos envolvidos
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Na infeção por HIV, existe uma classe de indivíduos, os “elite controllers”, que são um grupo raro de indivíduos que conseguem suprimir a carga viral a níveis indetetáveis, com contagem de linfócitos T-CD4+ elevada sem o uso de terapêutica antirretroviral (ART).
Este é um grupo bastante heterogéneo de indivíduos, podendo variar nas suas características virológicas e imunológicas, assim como pelo tempo de controlo do HIV.
Os mecanismos subjacentes a este paradigma não são totalmente compreendidos, embora existam boas evidências de que a resposta do hospedeiro, incluindo a resposta imunitária celular T- CD4 e CD8, bem como fatores genéticos, desempenham o papel mais importante na manutenção da supressão viral.
Ainda há muito a compreender sobre os mecanismos associados aos “elite controllers”, sendo particularmente importante a sua compreensão, uma vez que representam um modelo de “cura funcional”, podendo ser a chave para uma nova era de prevenção e gestão da infeção por HIV.
In HIV infection, there is a class of individuals, the elite controllers, who are a rare group of individuals who are able to suppress the viral load to undetectable levels, with a high CD4+ T lymphocyte count without the use of antiretroviral therapy (ART). This is a very heterogeneous group of individuals, which may vary in their virological and immunological characteristics, as well as the length of time they have had HIV control. The mechanisms underlying this paradigm are not fully understood, although there is good evidence that the host response, including the CD4 and CD8 T cell immune response, as well as genetic influences, play the most important role in maintaining viral suppression. There is still much to understand about the mechanisms associated with elite controllers and their understanding is particularly important, as they represent a model of functional cure and could be the key to a new era of HIV prevention and management.
In HIV infection, there is a class of individuals, the elite controllers, who are a rare group of individuals who are able to suppress the viral load to undetectable levels, with a high CD4+ T lymphocyte count without the use of antiretroviral therapy (ART). This is a very heterogeneous group of individuals, which may vary in their virological and immunological characteristics, as well as the length of time they have had HIV control. The mechanisms underlying this paradigm are not fully understood, although there is good evidence that the host response, including the CD4 and CD8 T cell immune response, as well as genetic influences, play the most important role in maintaining viral suppression. There is still much to understand about the mechanisms associated with elite controllers and their understanding is particularly important, as they represent a model of functional cure and could be the key to a new era of HIV prevention and management.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2024, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Controladores de elite HIV SIDA Linfócitos T-CD4+ Linfócitos T-CD8+ Mestrado integrado - 2024