hcv–hiv coinfection simple messages from a complex diseasehcv-hiv合并感染简单的消息从一种复杂的疾病.pdfVIP

Research In Translation HCV–HIV Coinfection: Simple Messages from a Complex Disease * Paul Klenerman , Arthur Kim epatitis C virus (HCV) and HIV infection are both major global health H problems, each with their own specific unsolved and difficult issues of prevention, pathogenesis, and therapy. For HIV, many of the clinical problems experienced are related to loss of immunological control over relatively commonly encountered pathogens. In most of these cases (e.g., cytomegalovirus [CMV], Pneumocystis jiroveci, human herpesvirus-8), normal immunological control is quite efficient, and these organisms behave as “opportunists.” HCV is slightly different, in that immunological control in normal HIV-uninfected individuals is often poor, and HCV infection alone can lead to the gradual evolution of end- stage liver disease in normal hosts. However, although a consensus is doi:10.1371/journal.pmed.0040240.g001 forming about the basic details of the immune responses associated with Figure 1. Immunologic Control of HCV Pathogenesis acute control of HCV monoinfection, In a normal HCV monoinfection, HCV-specific CD4 and CD8 T cells are mobilized to contain the long-term relationships between infection. If infection is not cleared, such T cells contribute to antiviral effects, proinflammatory effects, and regulatory effects. There is emerging evidence that the high viral loads of HCV during immune responses, viral load, and most coinfection with HIV are associated with profound defects in HCV-specific CD4 and also CD8 T importantly, disease progression in cell responses. There are some data showing that the cytokine environment in the liver is altered, those who are persistently infected are wh