静脉药瘾者多病毒感染与T细胞亚群关系  

Study on blood-borne virus co-infection and T lymphocyte subset in intravenous drug users

作　　者：田昆仑[1] 吴建新[1] 苏娟[1] 杨志华[1] 李建蓉[2] 

机构地区：[1]大理学院基础医学院,云南大理671000 [2]华中科技大学同济医学院

出　　处：《中国公共卫生》2009年第6期742-744,共3页Chinese Journal of Public Health

基　　金：国家自然科学基金(30160083)

摘　　要：目的研究静脉药瘾者(IDU)血源性病毒感染及重叠感染状况、T细胞亚群变化与多重病毒感染的关系。方法以406名无肝炎病史的静脉药瘾者为研究对象,用酶联免疫吸附法、免疫层析法和多聚酶链反应检测血源传播的常见病毒的感染标志物,用免疫荧光法检测T细胞;用ELISA和放射免疫法检测诱生的细胞因子和血清的细胞因子。选取同一地区102名健康体检者作对照。结果在406例静脉药瘾者中,乙肝病毒(HBV)、丙肝病毒(HCV)、人类免疫缺陷病毒(HIV)、丁肝病毒(HDV)、戊肝病毒(HGV)和血源传染病毒(HCMV)感染率分别为36.45%,69.7%,47.3%,2.22%,1.97%和3.45%,均明显高于对照组,静脉药瘾者(61.81%)存在2种以上病毒感染。HIV易重叠HCV和HBV等病毒感染,重叠感染率为83.85%。对照组仅存在HBV感染17.65%(18/102)。静脉药瘾者的CD3+和CD4+细胞比例减少,CD8+细胞比例无明显变化,单个核细胞诱生的IL-4、IFN-γ以及血清IL-2减少,血清IL-4增高(P<0.01)。发生HIV感染或HIV重叠HCV/HBV病毒感染时,诱生的IFN-γ和CD4+细胞比例进一步降低。HIV合并HBV感染的静脉药瘾者,51.72%表现HBV-DNA阳性和37.93%的HBeAg阳性;但无HIV感染时,HBV-DNA阳性率仅为1.68%。结论静脉药瘾者易出现多种病毒感染,主要是HIV、HCV和HBV的感染。静脉药瘾者Th1细胞功能减弱,出现HIV感染或重叠感染使Th1/Th2细胞平衡紊乱,进一步证实了HIV可能通过减弱Th1细胞功能,促进HBV的复制。Objective To investigate the features of various blood-borne virus infection and co-infection in intravenous drag users（IDU）. The correlation of T lymphocyte subsets and virus co-infection was examined. Methods A study population of 406 IDU consisted of 383 males and 23 females. All subjects had no clinical manifestation of hepatitis. HBV-DNA and HCV-RNA were identified by fluorescence quantitative polymerase chain reaction. HBsAg, HBeAg, anti-HCV, HDV- Ag,anti-HGV, anti-HIV, and HCMV-IgM were assayed by enzyme-linked immunosorbent assay （ELISA） and immuno- chromatographic tests. The levels of cytokines of Thl and Th2 were measured by ELISA and radioactive immune assay （RIA）. T lymphocyte subpopulation was detected by means of fluorescence immunoassay. The indices taken from 102 healthy persons served as control. Results The infection rate of the vires among IDU was 36.45% for HBV,69. 7% for HCV,47.3% for HTV,2. 22% for HDV, 1.97% for HGV,and 3.45% for HCMV,respectively. The co-infection rate of blood-borne virus was detected in 255 of 406（61.81% ） subjects. Triple infection and fourfold infection were detected in the study. More than 80% （161/192） of subjects infected with HIV were co-infected with the other virus（ HBV or HCV）. In contrast,among the controls,the infection rate was 17. 65% for HBV and 0% for other viruses. There was a profound de- crease in the proportion of CD4/CD8 and the percentage of CD3 and CD4, but no decrease in the percentage of CD8. The levels of PHA-induced cytokines（IFN-~/ and IL-4） and the level of serum IL-2 were obviously decreased in IDU. On the other hand,the level of serum IL-4 was increased. The level of IFN--/ and the percentage of CD4 were continuously de- creased when the IDU was infected with HIV or HIV co-infection. IDU with HIV and HBV co-infection was 15. 1% and 51.72%. 37. 93% of the subjects were HBV-DNA positive and HBeAg positive when there was HIV and HBV co-infection. Only 1. 68% （2/119） of/DU without HIV infection were HBV-DNA positi

关 键 词：静脉药瘾者 T细胞亚群 血源传播病毒 重叠感染 

分 类 号：R163[医药卫生—公共卫生与预防医学]