Article information
Resumen
La historia natural de la infección por el virus de la inmunodeficiencia humana tipo 1 (VIH-1) es un proceso variable que ha permitido identificar individuos con diferentes patrones de progresión de la infección. Entre estos individuos, existe un grupo de personas catalogadas como, sin progresión a largo plazo, las cuales se caracterizan por permanecer asintomáticas por largos periodos, sin evidencia de deterioro inmunológico y con cargas virales bajas o indetectables, en ausencia de tratamiento antirretroviral. Diferentes factores inmunológicos, genéticos y virales se han asociado con el patrón de progresión exhibido por estos individuos. Los factores inmunológicos contemplan mecanismos tanto de la inmunidad innata como de la adaptativa; los factores genéticos están relacionados con los genes que codifican los receptores de quimiocinas y sus ligandos naturales y genes del complejo mayor de histocompatibilidad. Por otro lado, los factores virales están relacionados con la variabilidad genética del virus y con su capacidad de replicación.
De la forma en que estos factores se interrelacionen, dependen la capacidad infecciosa del virus, la respuesta inmune anti-VIH que pueda establecer el hospedero y, por consiguiente, el patrón de progresión que se establezca.
Palabras clave:
VIH-1
progresión a largo plazo
resistencia natural
Summary
The natural history of type one human immunodeficiency virus infection (HIV-1) is a variable process that has allowed identifying different patterns of progression. Among them, there is a group of individuals known as long-term non-progressors (LTNP). LTNP are characterized for being asymptomatic for long periods of time, showing no evidence of immune deterioration and having low or undetectable viral loads in absence of antiretroviral treatment. Different immunologic, genetic and viral factors have been associated with the pattern of progression. Immunological factors include both, innate and adaptive mechanisms; genetic factors are related with genes of the chemokines family as well as genes of the major histocompatibility complex. On the other hand, viral factors are related to the genetic variability and replication ability of the virus. The disease pattern that is established depends on the interrelations of all these factors, which finally account for the type of anti- HIV-1 immune response developed and the infectious capacity of the virus.
Key words:
HIV-1
long-term non-progressors
natural resistance
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