HIV/AIDS患者病毒载量与细胞免疫功能及辅助受体CCR5/CXCR4的相关性  

Correlation between viral load and cellular immune function,co-receptors CCR5/CXCR4 in HIV/AIDS patients

作　　者：王淑虹 陈定 邓楠 张怡 郑敏红 李亮 WANG Shu-hong;CHEN Ding;DENG Nan;ZHANG Yi;ZHENG Min-hong;LI Liang(Hongshan District Center for Disease Control and Prevention,Wuhan,Hubei430070,China)

机构地区：[1]武汉市洪山区疾病预防控制中心检验科,湖北武汉430070 [2]武汉市洪山区妇幼保健院妇产科,湖北武汉430070

出　　处：《中华医院感染学杂志》2022年第19期2925-2929,共5页Chinese Journal of Nosocomiology

基　　金：湖北省卫健委科研基金资助项目(WJ2019M014)。

摘　　要：目的探讨人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者病毒载量与细胞免疫功能及辅助受体CC趋化性细胞因子受体5(CCR5)/CXC趋化性细胞因子受体4(CXCR4)的相关性。方法选取2020年2月-2021年3月武汉市洪山区疾病预防控制中心备案的HIV/AIDS患者198例,通过全自动病毒载量仪检测患者血浆病毒载量,并采用流式细胞仪检测外周血T淋巴细胞CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)及CD_(4)^(+)、CD_(8)^(+)T淋巴细胞上辅助受体CCR5、CXCR4的表达,分析病毒载量与细胞免疫功能及辅助受体CCR5/CXCR4的相关性。结果本研究198例患者病毒载量分布包括<10^(3)拷贝/ml者16例,10^(3)~10^(4)拷贝/ml者41例,10^(4)~10^(5)拷贝/ml者79例,>10^(5)拷贝/ml者62例;CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均为病毒载量10^(5)拷贝/ml以上患者<10^(4)~10^(5)拷贝/ml患者<10^(3)~10^(4)拷贝/ml患者<10^(3)拷贝/ml以下患者(P<0.05);CD_(4)^(+)计数病毒载量10^(5)拷贝/ml以上患者>10^(4)~10^(5)拷贝/ml患者>10^(3)~10^(4)拷贝/ml患者>10^(3)拷贝/ml以下患者(P<0.05);CD_(4)^(+)、CD_(8)^(+)表面CCR5均为病毒载量10^(5)拷贝/ml以上患者>10^(4)~10^(5)拷贝/ml患者>10^(3)~10^(4)拷贝/ml患者>10^(3)拷贝/ml以下患者(P<0.05);CD_(4)^(+)、CD_(8)^(+)表面CXCR4均为病毒载量10^(5)拷贝/ml以上患者<10^(4)~10^(5)拷贝/ml患者<10^(3)~10^(4)拷贝/ml患者<10^(3)拷贝/ml以下患者(P<0.05);病毒载量与T淋巴细胞CD_(4)^(+)计数及CD_(4)^(+)/CD_(8)^(+)水平呈现负相关,与CD_(4)^(+)计数水平呈现正相关(P<0.05);病毒载量与CD_(4)^(+)与CD_(8)^(+)表面辅助受体CXCR4^(+)呈现负相关,与CCR5^(+)呈现正相关(P<0.05)。结论HIV/AIDS患者CD_(4)^(+)T淋巴细胞计数与病毒载量呈现负相关,CD_(8)^(+)T淋巴细胞计数与病毒载量呈现正相关,同时随着病毒载量的升高,HIV/AIDS患者辅助受体CCR5的表达升高、CXCR4的表达降低。OBJECTIVE To explore the correlation between viral load and cellular immune function,co-receptors CC chemotactic cytokine receptor 5(CCR5)/CXC chemotactic cytokine receptor 4(CXCR4)in patients with human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS).METHODS A total of 198 patients with HIV/AIDS admitted to Hongshan District Center for Disease Control and Prevention,Wuhan,were enrolled between Feb.2020 and Mar.2021.The plasma viral load was detected by full-automatic viral load meter.The levels of peripheral blood T-lymphocytes(CD_(3)^(+),D_(4)^(+),CD_(8)^(+))and expressions of co-receptors(CCR5,CXCR4)on CD_(4)^(+)and CD_(8)^(+)were detected by flow cytometry.The correlation between viral load and cellular immune function,co-receptors CCR5/CXCR4 was analyzed.RESULTS Of the 198 patients,there were 16 cases with viral load<10^(3)copies/ml,41 cases within 10^(3)-10^(4)copies/ml,79 cases within 10^(4)-10^(5)copies/mL and 62 cases>10^(5)copies/ml.The levels of CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)were the highest in patients with viral load<10^(3)copies/ml,followed by 10^(3)-10^(4)copies/ml,10^(4)-10^(5)copies/ml and>10^(5)copies/ml(P<0.05),while CD_(4)^(+)count was on the contrary(P<0.05).The expression level of CCR5 on the surface of CD_(4)^(+)and CD_(8)^(+)was the highest in patients with viral load>10^(5)copies/ml,followed by 10^(4)-10^(5)copies/ml,10^(3)-10^(4)copies/ml and<10^(3)copies/ml(P<0.05),while expression level of CXCR4 was on the contrary(P<0.05).The viral load was negatively correlated with CD_(4)^(+)count and CD_(4)^(+)/CD_(8)^(+)level,while positively correlated with CD_(8)^(+)count(P<0.05).The viral load was negatively correlated with CXCR4,while positively correlated with CCR5(P<0.05).CONCLUSION CD_(4)^(+)T lymphocyte count is negatively correlated with viral load,while CD_(8)^(+)T lymphocyte count is positively correlated with it in HIV/AIDS patients.With the increase of viral load,CCR5 is increased,while CXCR4 is decreased.

关 键 词：人类免疫缺陷病毒 获得性免疫缺陷综合征 病毒载量 细胞免疫功能 CC趋化性细胞因子受体5 CXC趋化性细胞因子受体4 

分 类 号：R512.91[医药卫生—内科学]