急性HIV感染者HLA-A、B携带Bw4簇对CD4 T细胞计数、病毒载量的影响  

Influence of HLA-A, B loci carrying Bw4 motif on HIV CD4 T cell count and viral load

作　　者：张欣[1] 闫惠平[1] 杨红兵[2] 李伟华[1] 张海萍[1] 计云霞[1] 崔丹[1] 

机构地区：[1]首都医科大学附属北京佑安医院感染与免疫研究中心,100069 [2]英国牛津大学医学研究所

出　　处：《中华医学杂志》2010年第32期2242-2245,共4页National Medical Journal of China

基　　金：基金项目：北京市科委项目（130906003040391、1）0905070359094）;北京市卫生局青年科学研究资助项目（QN2008-032）

摘　　要：目的 观察急性人类免疫缺陷病毒（HIV）感染者人类白细胞抗原（HLA）A、HLA-B携带Bw4簇对其CD4 T细胞计数、病毒载量的影响.方法 用序列特异性引物-聚合酶链反应（SSP-PCR）对2006-2009年北京及其周边地区的95例急性HIV感染者的HLA-A、B等位基因分型,检测CD4 T细胞计数和病毒载量,分析HLA-A、B携带Bw4对急性HIV感染者CD4 T细胞计数、病毒载量的影响.结果 （1）在95例急性HIV感染者中,HLA-A、HLA-B携带Bw4分别占32.6%（31/95）、60.0%（57/95）.HLA-B携带Bw4/4、Bw4/6、Bw6/6的感染者分别为21.1%（20/95）、38.9%（37/95）、40.0%（38/95）.（2）与CD4 T细胞计数＜500个/μl患者比较,CD4 T细胞计数≥500个/μl患者携带Bw4数量更多（平均秩次：56.7比41.6,U=749.5,P＜0.01）.最少的感染者是HLA-A、B携带3个Bw4且CD4 T细胞＜500个/μl（1例）,其次是HLA-A、B携带0或3个Bw4且CD4 T细胞≥500个/μl（均为7例,x2=12.6,P＜0.01）.（3）HLA-A、B携带0或1个Bw4的感染者其CD4 T细胞计数均低于携带3个Bw4的感染者（中位数：430、425个/μl比651个/μl）,而病毒载量均高于携带3个Bw4的感染者（对数值,中位数：4.48、4.40比3.43,均P＜0.05）.但是HLA-A、B携带2个或3个Bw4的感染者CD4T细胞计数和病毒载量差异均无统计学意义（均P＞0.05）.（4）不考虑HLA-A是否携带Bw4,HLA-B携带Bw4/4纯合子的感染者其CD4 T细胞计数（中位数：538个/μl））显著高于HLA-B携带Bw4/6或Bw6/6的感染者（433、427个/μl）而病毒载量（对数值,中位数：3.53）显著低于HLA-B携带Bw4/6或Bw6/6的感染者（4.29、4.48,均P＜0.05）.而不考虑HLA-B是否携带Bw4,HLA-A携带Bw4与不携带Bw4的感染者比较,CD4 T细胞计数和病毒载量差异无统计意义（P＞0.05）.结论 Bw4可能与HIV感染者高CD4 T细胞计数、低病毒载量有关,并且可能是HLA-B携带Bw4/4纯合子起作用,从而延缓疾病进展.Objective To analyze the influence of Bw4 motif carried by HLA-A, B loci on CD4 T cell count and viral load of primary HIV infectors. Methods The technique of SSP-PCR was employed to detect the HLA-A, B allele typing in 95 HIV infectors. And the roles of Bw4 motif carried by HLA-A, B loci on CD4 T cell count and viral load were analyzed. Results （ 1 ） The population frequency of HLA-A, B loci carrying Bw4 motif was respectively 32. 6% （31/95） and 60. 0% （57/95）. The population frequency of Bw4/4, Bw4/6, Bw6/6 located on HLA-B was 21.1% （20/95）, 38.9% （37/95） and 40.0%（38/95） respectively. （2）Compared with those with CD4 T cell count less than 500/μl, more Bw4 motifs were expressed on HLA-A, B loci of patients with CD4 cell count more than 500/μl （mean rank,56. 7 vs 41.6,U=749. 5, P〈0. 01 ）. Moreover, the fewest infectors were those with HLA-A, B carrying 3 Bw4 motifs and CD4 T cell count fewer than 500/μl（ 1 case）. And secondly were those with HLA-A, B carrying 0 or 3 Bw4 motif and CD4 cell count more than 500/μl （7 cases,x2 = 12. 6, P 〈0. 01 ）. （3）The infectors with HLA-A, B loci carrying 3 Bw4 motifs had more CD4 T cell count（ median： 65 1/μl）and less viral load （lg median： 3.43 ） than those with HLA-A, B carrying 0 or 1 Bw4 motif（430 and 425/μl,4. 48 and 4. 40）.And the difference was significant （all P 〈0. 05 ）. However, the CD4 cell count and viral load between the patients with HLA-A, B carrying 2 Bw4 motifs and 3 Bw4 motifs were insignificantly different （P 〉0. 05）.（4） Irrespective of Bw4 motif on HLA-A locus, the infectors HLA-B carrying Bw4/4 homozygote had more CD4 cell count （median： 538/μl） and less viral load （lg median： 3.53） than those carrying Bw4/6 heterozygote or Bw6/6 homozygote （ 433/μl and 427 /μl,4. 29 and 4. 48, all P 〈 0. 05 ） . However,irrespective of Bw4 motif on HLA-B, the CD4 cell count and viral load were insignificantly different between the infectors HLA-A carrying Bw4 motif and

关 键 词：HIV感染 HLA-A抗原 HLA-B抗原 Bw4 

分 类 号：R51[医药卫生—内科学]