基线极高HIV-1 RNA水平对初治HIV-1感染者外周血total HIV-1 DNA的影响  

Impact of very high baseline HIV-1 RNA level on the decay of total HIV-1 DNA in the peripheral blood of HAART-naive HIV-1 infected patients

作　　者：徐玲 岳永松 韩扬[1] 祝婷[1] 宋晓璟[1] 李雁凌[1] 李太生[1] Xu Ling;Yue Yongsong;Han Yang;Zhu Ting;Song Xiaojing;Li Yanling;Li Taisheng(Department of Infectious Diseases,Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院感染内科,100730

出　　处：《国际病毒学杂志》2021年第2期140-144,共5页International Journal of Virology

基　　金：国家十三五科技重大专项课题(2017ZX10202101-001);中国医学科学院医学与健康科技创新工程项目(2017-I2M-1-014)。

摘　　要：目的观察基线HIV-1 RNA>50万copies/mL的HIV-1感染者,在高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)前后外周血totalHIV-1 DNA的变化。方法从国家十二五科技重大专项课题中选取基线HIV-1 RNA>50万copies/mL且HAART 96周HIV-1 RNA<50 copies/mL的初治HIV-1感染者为试验组,年龄性别相当的基线HIV-1 RNA<50万copies/mL的HIV-1感染者为对照组。检测两组患者基线和HAART 24、48、96周时total HIV-1 DNA水平。结果基线及HAART 96周,试验组total HIV-1 DNA均高于对照组3.48(3.21~3.80)lg copies/106 PBMCsvs 2.90(2.54~3.30)lg copies/106 PBMCs(p<0.001),2.82(2.38~2.96)lgcopies/106 PBMCs vs 2.37(1.99~2.65)lg copies/106 PBMCs(p=0.001)。HAART 24周、48周,试验组detal HIV-1 DNA较对照组高0.67(0.41~1.03)lg copies/106 PBMCs vs 0.39(0.09~0.73)lg copies/106 PBMCs(P<0.001),0.8(0.46~1.16)lg copies/106 PBMCs vs 0.43(0.04~0.63)lg copies/106 PBMCs(P<0.001)。且HAART前后total HIV-1 DNA水平均与基线病载正相关。结论基线极高病载患者HAART 96周内存在较高total HIV DNA水平,建议选择强效HAART方案来有效降低储存库。Objective To observed the impact of HIV-1 RNA>500000 copies/mL at baseline on the decay of total HIV-1 DNA in HIV-1 infected patients before and after highly active antiretroviral therapy(HAART).Methods From the National Key Science and Technology Project of the 12th Five-year Plan Period,HIV-1 HAART-naive patients with HIV-1 RNA>500000 copies/mL at baseline were recruited as the study group and HIV-1 HAART-naive patients with matched age and gender,and HIV-1 RNA<500000 copies/mL at baseline were selected as controls.Total HIV-1 DNA was quantified with peripheral blood at 0,24,48 and 96 weeks after HAART.Results Compared with the controls,total HIV-1 DNA levels at the baseline and 96 weeks after HAART in the study group were higher,namely,3.48(3.21-3.80)lg copies/106 PBMCs vs 2.90(2.54-3.30)lg copies/106 PBMCs(P<0.001),and 2.82(2.38-2.96)lg copies/106 PBMCs vs 2.37(1.99-2.65)lg copies/106 PBMCs(P=0.001),respectively.Moreover,the detal HIV-1 DNA levels at 24 and 48 weeks after HAART in the study group were higher,namely,0.67(0.41-1.03)lg copies/106 PBMCs vs 0.39(0.09-0.73)lg copies/106 PBMCs(P<0.001),0.8(0.46-1.16)lg copies/106 PBMCs vs 0.43(0.04-0.63)lg copies/106 PBMCs(P<0.001),respectively.Both the levels of total HIV-1 DNA at baseline and after HAART were positively correlated to the baseline viral loads.Conclusions HIV-1 infected patients with very high baseline HIV-1 RNA levels presented higher total HIV-1 DNA level within 96 weeks after HAART.More potent initial HAART regimens should be considered to decrease total HIV-1 DNA.

关 键 词：基线极高HIV-1 RNA total HIV-1 DNA HIV-1感染者 HAART 

分 类 号：R512.91[医药卫生—内科学]