HIV感染前后血浆CCL3水平变化与疾病进展的关系  

Relationship between changes of plasma CCL3 levels and disease progression pre-and post-HIV infection

作　　者：葛泓池 尹晓婉 王卓 王悦 张子宁[1] 丁海波[1] 韩晓旭[1] 姜拥军[1] GE Hongchi;YIN Xiaowan;WANG Zhuo;WANG Yue;ZHANG Zining;DING Haibo;HAN Xiaoxu;JIANG Yongjun(NHC Key Laboratory of AIDS Immunology,China Medical University,National Clinical Research Center for Laboratory Medicine,Key Laboratory of AIDS Immunology of Liaoning Province,Department of Laboratory Medicine,the First Affiliated Hospital of China Medical University,Shenyang 110001,Liaoning,China;The Second Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu)

机构地区：[1]中国医科大学附属第一医院检验科,国家卫生健康委员会艾滋病免疫学重点实验室,国家医学检验临床医学研究中心,辽宁省艾滋病免疫学重点实验室,沈阳110001 [2]苏州大学附属第二医院,江苏苏州215000

出　　处：《中国艾滋病性病》2021年第10期1052-1058,共7页Chinese Journal of Aids & STD

基　　金：国家“十二五”科技重大专项(2012ZX10001-006);国家“十三五”科技重大专项(2017ZX10201101)。

摘　　要：目的探究HIV感染前后血浆CCL3水平变化、急性期血浆CCL3水平与CD4细胞数量及病毒载量之间的关系,评估其对HIV感染的疾病进展的预测能力。方法选取中国医科大学附属第一医院红丝带门诊HIV感染者54例,对其感染前和急性期感染的血浆CCL3、CD4细胞数量以及病毒载量进行检测。结果HIV感染前后CCL3升高倍数高组的病毒载量明显高于升高倍数低组(P=0.006);急性期血浆CCL3水平高组在感染120天和感染1年时的CD4细胞数量均低于CCL3水平低组(P=0.0182;P=0.0013),且急性期血浆CCL3水平与CD4/CD8比值均呈负相关关系(r=-0.5620,P=0.0004;r=-0.6144,P=0.0004);ROC曲线分析显示CCL3升高倍数对感染120天的病毒载量的预测价值为75.2%(P=0.0214),Kaplan-Meier生存分析显示CCL3升高倍数高于1.215的HIV感染者,其发生高病毒载量(lg拷贝/mL≥4)结局事件所用时间更短(P=0.0103);ROC曲线分析显示急性期血浆CCL3水平对感染1年的CD4细胞数量和病毒载量水平的预测价值为81.25%(P=0.0357),Kaplan-Meier生存分析显示急性期血浆CCL3水平高于2.855 pg/mL的HIV感染者,其感染120天后发生低CD4细胞数(<500个/μL)和高病毒载量(lg拷贝/mL≥4)的结局事件所用时间更短(P=0.0192)。结论HIV感染前后血浆CCL3水平升高倍数大及急性期血浆CCL3水平表达高预示着HIV感染者较快的疾病进展。Objective To explore the changes of plasma CCL3 level before and after HIV infection,and the relationship between plasma CCL3 level in the acute phase and the number of CD4 cells and viral load,aiming to evaluate its ability to predict the progress of HIV disease.Methods 54 HIV-infected patients in the red ribbon clinic of the First Affiliated Hospital of China Medical University were selected.The number of plasma CCL3 and CD4 cells and viral load before and during acute infection were detected.Results Before and after HIV infection,the viral load of the group with high CCL3 increase was significantly higher than that of the group with low CCL3 increase(P=0.006);The number of CD4 cells in the group with high plasma CCL3 level at 120 days and one year of infection was lower than that in the group with low CCL3 level(P=0.0182;P=0.0013),and there was a negative correlation between plasma CCL3 level and CD4/CD8 ratio(r=-0.5620,P=0.0004;r=-0.6144,P=0.0004);ROC curve analysis showed that the predictive value of CCL3 increase multiple on the viral load at 120 days of infection was 75.2%(P=0.0214).Kaplan Meier survival analysis showed that HIV-infected people with CCL3 increase higher than 1.215 took less time to develop the outcome event of high viral load(lg copies/m L≥4,P=0.0103).ROC curve analysis showed that the predictive value of plasma CCL3 level in the acute phase on the number of CD4 cells and viral load level in one year of infection was 81.25%(P=0.0357).Kaplan Meier survival analysis showed that HIV infected persons with plasma CCL3 levels higher than 2.855 pg/ml in the acute phase took a shorter time(P=0.0192)to develop the outcome events of having low CD4 cell number(<500 cells/μL)and high viral load(lg copies/mL≥4)120 days after infection.Conclusion Increases in plasma CCL3 level before and after HIV infection and the high expression of plasma CCL3 level in the acute stage indicated the rapid disease progression of HIV-infected patients.

关 键 词：CCL3 艾滋病病毒 病毒载量 CD4细胞 疾病进展 

分 类 号：R512.91[医药卫生—内科学]