HIV-1感染者不同免疫状态的抗体及病毒载量研究  

Study on the antibodies and viral load of HIV-1 infected individuals with different immune status

作　　者：林倩茹 于贺军[2] 张辉[1] 李桂英[3] 孙燕鸣[3] 杨敏 金晓媚[4] 马丽英[1] 金聪[1] 肖瑶[1] Lin Qianru;Yu Hejun;Zhang Hui;Li Guiying;Sun Yanming;Yang Min;Jin Xiaomei;Ma Liying;Jin Cong;Xiao Yao(National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Xinxiang Prefecture Center for Disease Control and Prevention,Xinxiang 453000,China;Beijing Center for Disease Control and Prevention,Beijing 100013;Institute for AIDS/STD Control and Prevention,Yunnan Provincial Center for Disease Control and Prevention,Kunming 650022,China)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]新乡市疾病预防控制中心,453000 [3]北京市疾病预防控制中心性病艾滋病防治所,100013 [4]云南省疾病预防控制中心性病艾滋病防治所,昆明650022

出　　处：《中华实验和临床病毒学杂志》2021年第2期147-151,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：国家"十三五"科技重大专项(2017ZX10201101-002-003)。

摘　　要：目的了解不同免疫抑制程度下HIV-1感染者的病毒学及免疫学指标差异,分析HIV-1感染者初筛检测结果S/CO值,病毒载量检测结果以及WB带型与免疫状态之间的相关性。方法对2017-2019年河南省、北京市和云南省三个现场的639份抗病毒治疗前HIV-1抗体确证阳性样本,根据CD4细胞计数分成4个不同免疫抑制组:无免疫抑制组(CD4≥500个/μl),轻度免疫抑制组(350个/μl≤CD4<500个/μl),中度免疫抑制组(200个/μl≤CD4<350个/μl),重度免疫抑制组(CD4<200个/μl)。采用χ2检验比较不同免疫抑制组之间S/CO值、WB带型的差异,分析各项指标与免疫状态的关系。结果各免疫抑制组的S/CO值>20出现率最高(>37%)且随机体免疫力增强呈递减趋势(P<0.05),1<S/CO≤6出现率次高(>19%),0<S/CO≤1出现率最低(<3%),6<S/CO≤10出现率次低(<5%),S/CO值(χ2=25.79,P<0.05)的分布在不同免疫抑制组间的差异均有统计学意义;各免疫抑制组中膜蛋白(ENV)gp160、gp120、gp41及酶蛋白(pol)p66、p55、p31的出现率最高(>78%),而核心蛋白(gag)的p55(<40%)、p39(<3%)出现率最低,gp41和p51的出现率在不同免疫抑制组间的差异均有统计学意义(P<0.05)。S/CO值结合病毒载量时对无、轻、中、重度免疫抑制组判定的曲线下面积分别为0.651(95%CI:0.600~0.702;P<0.05),0.587(95%CI:0.540~0.635;P<0.05),0.605(95%CI:0.560~0.650;P<0.05),0.647(95%CI:0.586~0.708;P<0.05)。结论 S/CO值联合病毒载量对于对无免疫抑制状态的判定效能最好;同时缺失gp41和p51,S/CO>20时可分别提示患者可能处于无免疫抑制状态和重度免疫抑制状态。Objective To investigate the differences in virological and immunological indicators of HIV-1 infected individuals with different degrees of immunosuppression,analyze the correlation between the sample/cutoff ratio(S/CO),viral load(VL),Western blot(WB)band type and immune status of HIV-1 infected individuals.Methods A total of 639 HIV-1 antibodies positive and treatment-naive samples from Henan,Beijing and Yunnan during the period of 2017-2019 were divided into three groups:no immunosuppression(CD4≥500 cells/μl),mild immunosuppressive(350cells/μl≤CD4<500cells/μl),moderate immunosuppression(200 cells/μl≤CD4<350 cells/μl),severe immunosuppression(CD4<200 cells/μl).Chi-square test was used to compare S/CO,WB band type among different immunosuppression groups,analyze the relationship between various indicators and immune status.Results In each immunosuppressive group,S/CO>20 had the highest occurrence rate(>37%),and showed a decreasing trend with the enhancement of immunity(P<0.05),the occurrence rate of 1<S/CO≤6 was the next highest(>19%),the occurrence rate of 0<S/CO≤1 was the lowest(<3%),the occurrence rate of 6<S/CO≤10 was the next lowest(<5%),the distribution of S/CO(χ^(2)=25.79,P<0.05)was statistically significant among different immunosuppression groups.The occurrence rates of gp160,gp120,gp41,p66,p55 and p31 were the highest in each immunosuppression group(>78%),while the occurrence rates of p55(<40%)and p39(<3%)were the lowest,the differences of the occurrence rates of gp41 and p51 among different immunosuppression groups were statistically significant(P<0.05).The area under the curve determined by S/CO value combined with viral load for no,mild,moderate and severe immunosuppression groups were respectively 0.651(95%CI:0.600-0.702;P<0.05),0.587(95%CI:0.540-0.635;P<0.05),0.605(95%CI:0.560~0.650;P<0.05),0.647(95%CI:0.586-0.708;P<0.05).Conclusions The S/CO value viral load was the best for the determination of non-immunosuppressive status;The absence of gp41 and p51,S/CO>20 suggest that the p

关 键 词：HIV-1 CD4 WB带型 S/CO值 联合指标 

分 类 号：R512.91[医药卫生—内科学]