Resistencia natural a la infección por el VIH-1. Revisión sistemática de la literatura
DOI:
https://doi.org/10.17533/udea.iatreia.216Palabras clave:
Inmunidad Innata, VIH-1, Revisión SistemáticaResumen
Introducción: la investigación sobre la infección por VIH-1 ha permitido identificar individuos que, a pesar de exponerse en múltiples ocasiones al virus, no presentan signos de infección. Se conocen como expuestos a VIH seronegativos o HESN (del inglés HIV-exposed seronegative). Esto sugiere la existencia de mecanismos de resistencia natural al VIH-1.
Objetivo: describir la información disponible en la literatura sobre los HESN y sus mecanismos de resistencia natural.
Métodos: se realizó una revisión sistemática de la literatura de enfoque amplio en seis bases de datos y se siguieron las etapas de la guía PRISMA. El análisis de la información se hizo con frecuencias absolutas, relativas y con un análisis de redes de colaboración científica en Ghepi.
Resultados: se encontraron 124 artículos que suman 4079 individuos HESN. La comunidad científica interesada en este tema estuvo conformada por 688 investigadores de Estados Unidos, Italia, Canadá, España, Brasil y Colombia. Los criterios para definir a un individuo como HESN fueron altamente variables. Se identificaron 33 mecanismos diferentes relacionados con la resistencia natural al VIH-1, dentro de los cuales el más común fue los factores solubles en mucosas y sangre periférica (30,6%), seguido por la mutación Δ32 (14,5%), los alelos KIR/HLA (10,5%) y la IgA neutralizante (10,5%).
Conclusiones: existe una comunidad científica consolidada con interés en estudiar la resistencia natural a la infección por VIH-1. Se observó una significante diversidad en los mecanismos inmunológicos involucrados en la resistencia natural al virus y una alta heterogeneidad en los criterios para definir las poblaciones como HESN.
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