一项研究提示，艾滋病病毒的毒力可能随着时间推移而衰退，这可能是由于对抗逆转录病毒疗法（ART）获取的增加，以及让艾滋病病毒规避针对它而产生的最有效的免疫应答的病毒突变的积累。为了评估针对艾滋病病毒的自然免疫以及增加抗逆转录病毒疗法（ART）对艾滋病病毒毒力的影响，R. P. Payne及其同事研究了博茨瓦纳和南非的艾滋病病毒流行，这两个国家受到了艾滋病病毒全球大流行的严重影响。在艾滋病病毒流行开始得更早，而且成年人的血清阳性率一直比南非更高的博茨瓦纳，这组作者观察到了艾滋病病毒已经适应了诸如HLA-B*57等HLA等位基因调控的保护性免疫应答。尽管HLA-B*57等位基因在博茨瓦纳不再携带任何保护作用，这个病原体规避有效的免疫应答的能力也为艾滋病病毒带来了一个成本，也就是这个病毒经历了复制效率降低。此外，通过独立的机制，ART使用的增加可能对艾滋病病毒毒力加速下降有贡献。这组作者说，这些联合起来的效应可能对成功消除艾滋病相关疾病的长期目标有贡献。
论文 #14-13339: “Impact of HLA-driven HIV adaptation on virulence in populations of high HIV seroprevalence,” 作者 RP Payne 等人
评论：Immune pressure exerted by the host immune system, notably by the HLA-mediated immune response, drives HIV to undergo adaptation mutations. In this investigation by Payne et al., the authors comparatively analysed HIV virulence and HIV immune adaptation in cohorts from Botswana and South Africa. In Gaborone, Botswana, where the epidemic started earlier, HIV showed reduced viral replication capacity (VRC), better adaptation to HIV-resistant alleles, such as HLA HLA-B*57/58:01, and increased HIV CTL epitopes, as compared with that in Durban, South Africa, where HIV epidemics are believed to have been preceded by Botswana by several years. This result indicates that HIV virulence has been decreasing over the years, probably in order to better adapt to host immune pressure. In addition, the authors also pointed out that in Botswana, anti-retroviral therapy (ART) started earlier, which may have also played a role in this decrease in HIV virulence. Yufei Wang
相关阅读：http://tagbasicscienceproject.typepad.com/tags_basic_science_vaccin/2014/12/is-hiv-weakening-over-time.html
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