少数民族地区静脉药瘾者多病毒感染及与T细胞亚群变化的研究  

STUDY ON YUNNAN MINORITY THE BLOOD-BORNE VIRUS CO-INFECTION AND T LYMPHOCYTE SUBSET AMONG INTRAVENOUS DRUG USERS

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

机构地区：[1]云南大理学院基础医学院,大理671000

出　　处：《现代预防医学》2010年第2期302-305,共4页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(N0.30160083)

摘　　要：[目的]研究云南少数民族地区静脉药瘾者(IDU)血源性病毒感染、重叠感染状况以及T细胞亚群变化与多重病毒感染的关系。[方法]以406名无肝炎病史的云南少数民族地区IDU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(HBV等)的感染标志物,用免疫荧光法检测CD3、CD4和CD8T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。同时选取同一地区102名健康体检者作对照。[结果]在406例IDU中,HBV、HCV、HIV、HDV、HGV和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,大多数IDU 62.81%,存在两种以上病毒感染。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%。IDU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。当HIV合并HBV感染的IDU,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]IDU易出现多种病毒感染,主要是HIV、HCV和HBV的感染。IDUTh1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 Drug Users（IDU）.The correlation of T lymphocyte subsets and virus co-infection was had no clinical manifestation of hepatitis.HBV-DNA and HCV-RNA were identified by fluorescence examined.[Methods] 406 IDU among Yunnan minority areas were collected,and HBsAg,HBeAg anti-HBc,anti-HCV,HDV-Ag,anti-HGV,anti-HIV,and HCMV-IgM were assayed by enzyme-lined immunosorbent assay（ELISA） and immunochromatographic tests.The levels of cytokines of Th1 and Th2 were measured by ELISA and radioactive immune assay（RIA）.T lymphocyte subpopulation was detected by means of fluorescence immunoassay.The similar indices taken from 102 healthy persons served as controls.[Results] Among 406 IDU,the infection rates of each virus were 36.45% for HBV,69.7% for HCV,47.3% for HIV,2.22% for HDV,1.97% for HGV,and 3.45% for HCMV,respectively,and these were significantly higher than controls.HIV was easy to infection with HCV and HBV,and the co-infection rate was 83.85%,however,the rate was only 17.65% among controls.Our investigation showed that an obviously decrease was found in the proportion of CD4 /CD8 and the percentage of CD3 and CD4,but the percentage of CD8 did not showed significant change.The levels of PHA-induced cytokines（IFN-γ and IL-4） and the level of serum IL-2 presented obviously decreased in IDU.On the other hand,the level of serum IL-4 was significantly increased.The level of IFN-γ and the percentage of CD4 were continuously decreased when the IDU was infected with HIV or HIV co-infection.IDU with HIV and HBV co-infection was 15.1%.HIV co-infection with HBV-DNA positive and HBeAg positive in IDU were 51.72% and 37.93%,respectively.But the HBV-DNA positive was only 1.68% among no-infection HIV.[Conclusion] HCV,HBV and HIV infection were common IDU.The function of IDU Th1 cell presents decreased in IDU,which could prompt HIV infection and HIV co-infection and disorder the balance between Th1 and Th2.It pro

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：R512.91[医药卫生—内科学]