HAART对HIV/AIDS患者T淋巴细胞活化及CD4+CD45RA+T细胞亚群的影响  

Effects of highly active anti-retroviral therapy(HAART)on T lymphocyte activation and CD4+CD45RA+T cell subsets in HIV/AIDS patients

作　　者：张亚兰[1] 郑海潮[1] 卫晓丽[1] 张海兰[1] 杨扬[1] 赵鑫[1] Zhang Yalan;Zheng Haichao;Wei Xiaoli;Zhang Hailan;Yang Yang;Zhao Xin(Department of AIDS Control and Prevention,Xi′an Center for Disease Control and Prevention,Xi′an 710054,China)

机构地区：[1]西安市疾病预防控制中心性病艾滋病防治科,710054

出　　处：《中华微生物学和免疫学杂志》2020年第7期518-522,共5页Chinese Journal of Microbiology and Immunology

基　　金：陕西省社会发展科技攻关项目(2015SF192)。

摘　　要：目的了解高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)后HIV/AIDS患者T淋巴细胞免疫活化及CD4+CD45RA+T细胞的亚群变化,探讨抗病毒治疗对HIV感染者免疫恢复的影响。方法前瞻性分析105例接受HARRT治疗的HIV/AIDS患者,流式细胞仪检测治疗前和治疗后1、3、6及12个月T淋巴细胞活化水平(CD38、HLA-DR的表达)及CD4+CD45RA+T淋巴细胞;同时选取未暴露且HIV-1抗体检测阴性者35名作为健康对照。结果HAART治疗前HIV/AIDS患者T淋巴细胞活化水平显著高于健康对照(P<0.01),HAART治疗后随治疗时间延长活化水平明显下降,治疗1个月时CD4+CD38+HLA-DR+及CD8+CD38+、CD8+HLA-DR+T淋巴细胞首先出现降低,治疗6个月时包含CD8+CD38+HLA-DR+T在内的4项活化指标均明显下降,差异有统计学意义(P<0.01);治疗12个月与6个月相比,CD8+CD38+HLA-DR+T表达水平继续降低(P<0.01),而其余3项活化指标差异无统计学意义。但HAART治疗12个月后,4项活化指标仍全部高于健康对照组(P<0.01)。CD4+CD45RA+T淋巴细胞百分比在治疗前及治疗后12个月均明显低于健康对照组。结论HIV/AIDS患者在HAART治疗后6个月免疫活化水平降低,但HAART并不能使免疫活化逆转;HAART治疗也不能恢复HIV感染后降低的CD4+CD45RA+T淋巴细胞的水平。Objective To investigate the effects of highly active anti-retroviral therapy(HAART)on the activation of T lymphocytes and expression of CD4+CD45RA+T cell subsets in HIV/AIDS patients.Methods This study prospectively analyzed 105 HIV/AIDS patients undergoing HAART and 35 HIV-1-negative cases(healthy controls).Flow cytometry was used to detect the activation of T lymphocytes and the percentages of CD4+CD45RA+T cell subsets in whole blood samples taken from healthy controls and HIV/AIDS patients before and after therapy.Results The activation of T lymphocytes was significantly enhanced in the 105 HIV/AIDS patients than in the healthy controls before treatment(P<0.01).The activated T lymphocytes gradually decreased after HAART.Firstly,CD4+CD38+HLA-DR+,CD8+CD38+and CD8+HLA-DR+T lymphocytes decreased one month after therapy(P<0.05).Then,four indicators of T lymphocyte activation including the expression of CD8+CD38+HLA-DR+T lymphocytes decreased significantly six months after therapy(P<0.01).The percentage of CD8+CD38+HLA-DR+T lymphocytes detected 12 months after therapy was significantly lower than that analyzed six months after therapy(P<0.01).No significant difference was found in the expression of the other three indicators for activation(P>0.05).Twelve months after therapy,the four indicators for T lymphocyte activation in HIV/AIDS patients were still significantly higher than those of the control group(P<0.01).The percentages of CD4+CD45RA+T lymphocytes in HIV/AIDS patients were significantly lower than those in healthy controls before and 12 months after treatment(P>0.05).Conclusions HAART could reduce immune activation after six months of treatment,but could not reverse the activation nor restore the expression of CD4+CD45RA+T lymphocytes in HIV/AIDS patients.

关 键 词：人免疫缺陷病毒(HIV) 高效抗逆转录病毒治疗(HAART) 免疫活化 CD4+CD45RA+T淋巴细胞 免疫恢复 

分 类 号：R512.91[医药卫生—内科学]