HIV感染者的免疫学功能变化及其与病程发展的关系Change of Immune Function among Primary HIV Infections and AIDS Patients and Its Relationship of Disease Progression
何建凡,冯铁建,李良成,陈琳,杨继要
摘要(Abstract):
目的 分析HIV感染者/AIDS病人体内病毒复制和免疫功能变化及其与病程发展的关系。方法 应用定量RT-PCR、流式细胞计数和定量ELISA 方法分析55例HIV感染者(n=42)和AIDS病人(n=13)外周血血浆病毒载量、T淋巴细胞亚群和细胞因子浓度。结果 HIV感染者和 AIDS病人CD4细胞和血浆IL-2浓度低于正常人群(P<0.001),血浆 sIL-2R、TNF-α、NPT浓度高于正常人群(P<0.01);AIDS病人CD4细胞和IL-2浓度明显低于HIV感染者(P<0.001),而血浆病毒载量、sIL、-2R、TNF-α、sTNFR-I、NPT浓度明显高于HIV感染者(P<0.01),且随着CD4细胞水平降低呈明显上升趋势。CD4细胞、CD4/CD8比值和血浆IL-2水平随感染时间延长而不断下降,不同感染时间之间差异明显;机体感染HIV后CD4细胞年平均下降43/mm3,血浆sIL-2R、sTNFR-I、NPT年平均上升幅度分别为59.03pg/ml、38.69pg/ml、2.11ng/ml。各因素相关性分析显示:CD4细胞、CD4/CD8比值与感染时间,CD3、CD4、CD8细胞变化分别与血浆病毒载量、sTNFR-I、NPT之间有高度负直线相关性;而血浆sIL-2R分别与IL-6(P<0.001)、IL-10(P<0.001)、TNF-α(P<0.001)、sTNFR-I(P<0.005)、NPT(P<0.002)浓度变化间,以及IL-6与TNF-α(P<0.001)、NPT与IL-10(P<0.05)和 sTNFR-I(P<0.001),?
关键词(KeyWords): HIV感染者;病毒载量;细胞因子;T淋巴细胞亚群
基金项目(Foundation):
作者(Author): 何建凡,冯铁建,李良成,陈琳,杨继要
参考文献(References):
- 1 Tetali S, Bakshi S, Than S, et al. Plasma virus load evaluation in relation to disease progression in HIV infected children. AIDS Res Hum Retroviruses, 1998, 14(7) :571-577
- 2 Carre N, Boufassa F, Hubert JB, et al. Predictive value of viral load and other markers for progression to clinical AIDS after CD4+ cell count falls below 200/microL. SEROCO & HEMOCO Study Croup. Int J Epidemiol, 1998, 27(5) :897-903
- 3 Wilkinson DA, Operskalski EA, Busch MP, et al. A 32 pb deletion within the CCR5 locus protects against transmission of parenterally acquired human immunodeficiency virus but does not affect progression to AIDS- defining illness. J Infect Dis, 1998, 178(4): 1 163-1 166
- 4 Sulkowski MS, Chaisson RE, Karp CL, et al. The effect of acute infectious illnesses on plasma human immunodeficiency virus (HIV) type 1 load and the expression of serologic markers of immune activa-tion among HIV-infected adults. J Infect Dis, 1998, 178(6) :1 642 -1648
- 5 Poli, Kinter A, Justement JS, et al. Tumor necrosis factor alpha functions in an autocrine manner in the induction of human immunod-eficiency virus expression. Proc Natl Acad Sci U S A, 1990, 87(2): 782-785
- 6 Girardin E, Roux - Lombard P, Grau GE, et al. Imbalance between tumour necrosis factor - alpha and soluble TNE receptor concentrations in severe meningococcaemia. The J5 Study Group. Immunology, 1992,76(1):20-23
- 7 Al-Harthi L, Roebuck KA, Kessler H, et al. Inhibition of cytokine - driven human immunodeficiency virus type 1 replication by protease inhibitor. J Infect Dis, 1997, 176(5): 1 175-1 179
- 8 Sabin CA, Mocroft A, Bofill M, et al. Changes in lymphocyte subsets in human immunodeficiency viruspositive persons with < 5 CD4 T lymphocytes/mm3. J Infect Dis, 1998, 178(4) :1 166-1 169