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1、ThenewenglandjournalofmedicinebriefreportAbsenceofDetectableHIV-1ViremiaafterTreatmentCessationinanInfantDeborahPersaud,M.D.,HannahGay,M.D.,CarrieZiemniak,M.S.,YaHuiChen,B.A.,MichaelPiatak,Jr.,Ph.D.,Tae-WookChun,Ph.D.,MatthewStrain,M.D.,Ph.D.,DouglasRichman,M.D.,andKathe
2、rineLuzuriaga,M.D.SUMMARYAninfantborntoawomanwithhumanimmunodeficiencyvirustype1(HIV-1)infectionbeganreceivingantiretroviraltherapy(ART)30hoursafterbirthowingtohigh-riskexposure.ARTwascontinuedwhendetectionofHIV-1DNAandRNAonrepeattestingmetthestandarddiagnosticcriteriafo
3、rinfection.Aftertherapywasdiscontinued(whenthechildwas18monthsofage),levelsofplasmaHIV-1RNA,proviralDNAinperipheral-bloodmononuclearcells,andHIV-1antibodies,asassessedbymeansofclinicalassays,remainedundetectableinthechildthrough30monthsofage.Thiscasesuggeststhatveryearly
4、ARTininfantsmayaltertheestablishmentandlong-termpersistenceofHIV-1infection.early70millionpersonshaveacquiredHIV-1infectionsinceFromtheDepartmentofPediatrics,theepidemicwasrecognized,1buta“cure”hasbeendocumentedinoneJohnsHopkinsUniversitySchoolofMed-N2,3icine,Baltimore(D
5、.P.,C.Z.,Y.H.C.),Fred-person,knownas“theBerlinPatient.”AcureforHIV-1infectionoc-erickNationalLaboratoryforCancerRe-curredinthispersonafterheunderwenttreatmentforacutemyelogenousleukemiasearch,LeidosBiomedicalResearch,withtotalablativechemotherapy,radiationtherapy,andstem
6、-celltransplantationFrederick(M.P.),andtheLaboratoryofImmunoregulation,NationalInstituteofwithdonorcellshomozygousforchemokinereceptor5(CCR5)delta32,withas-AllergyandInfectiousDiseases,Nationalsociatedgraft-versus-hostdisease.ThecaseoftheBerlinPatientshowsthatlong-Instit
7、utesofHealth,Bethesda(T.-W.C.)lived,replication-competentHIV-1reservoirscanbereducedorclearedsufficiently—allinMaryland;theDepartmentofPe-diatrics,UniversityofMississippiMedi-topermitthediscontinuationofARTwithoutsubsequentviralrebound.WereportcalCenter,Jackson(H.G.);the
8、Universitydatafroma30-month-oldchildwhohadmetthestandarddiagnosticcriteriaforofCaliforniaSanDiego,LaJol
