HIV-1感染者治疗后的T淋巴细胞异常激活研究  

Abnormal Activation of T Cells in HIV-1 Infection After Antiretroviral Therapy

作　　者：郭悦 张燕琳[1] 朱丹 龚芳红[1] 高钰双 朱昆蓉[1] 李姗珊 GUO Yue;ZHANG Yan-lin;ZHU Dan;GONG Fang-hong;GAO Yu-shuang;ZHU Kun-rong;LI Shan-shan(Department of STD and AIDS Laboratory,Chengdu Center for Disease Control and Prevention,Chengdu 610041,China)

机构地区：[1]成都市疾病预防控制中心性病艾滋病检测科,成都610041

出　　处：《四川大学学报（医学版）》2023年第2期415-421,共7页Journal of Sichuan University(Medical Sciences)

基　　金：四川省卫健委普及应用项目(No.20PJ187)资助。

摘　　要：目的 探讨外周全血中异常激活的T淋巴细胞亚群与人类免疫缺陷病毒1型(HIV-1)感染者免疫功能恢复的关系,探讨HIV-1 DNA病毒库的大小与T淋巴细胞亚群的关系。方法 以2019年7月–2020年5月进行常规检测的HIV-1感染者为目标人群,入组时根据抗逆转录病毒疗法(antiretroviral therapy, ART)治疗后CD4+T细胞是否达到500 cells/μL,将HIV-1感染者分为两组,其中缺陷组76例,无缺陷组61例。同时选择22例未暴露且HIV-1抗体检测阴性者作为对照组。对以上3组人群的T细胞亚群进行检测,并对缺陷组44例和无缺陷组33例共计77例进行HIV-1 DNA病毒库检测。6个月后随访缺陷组和无缺陷组,收集缺陷组(74例)和无缺陷组(59例)共133例血液样本中的CD4+T细胞检测结果。结果 入组时,缺陷组的活化CD4+、CD8+T细胞含量均高于无缺陷组和对照组。缺陷组衰老CD4+T、CD8+T细胞含量与无缺陷组相当,均高于对照组,但仅在衰老CD8+T细胞上差异有统计学意义。缺陷组比对照组检出更高的效应记忆CD4+T和CD8+T细胞,无缺陷组只检出更高的效应记忆CD8+T细胞。缺陷组和无缺陷组均表现出比对照组更低水平的中心记忆CD4+T和CD8+T细胞,无缺陷组中心记忆CD4+T细胞比缺陷组还低。对于幼稚细胞而言,无缺陷组表现出更高水平的幼稚CD4+T细胞,缺陷组和无缺陷组的幼稚CD8+T细胞较对照组下降。HIV-1 DNA病毒库大小与CD4+T细胞数量和各T细胞亚群均无相关。活化CD4+T细胞、活化CD8+T细胞、中心记忆CD4+T细胞与6个月以后的后续CD4+T细胞数量呈负相关,r分别为-0.378、-0.334、-0.322(P<0.05);幼稚CD4+T细胞、幼稚CD8+T细胞与后续CD4+T细胞数量呈正相关,r分别为0.350、0.267(P<0.05)。结论 HIV-1感染者存在不同程度的T细胞亚群异常激活,部分T细胞亚群的异常激活与后续免疫功能的恢复有关,病毒库的大小与T细胞亚群无相关关系。Objective To investigate the relationship between abnormal activation of T cell subsets in peripheral whole blood and the recovery of immune function in persons infected with HIV-1, and to examine the relationship between the size of the viral reservoir of HIV-1 DNA and T cell subsets. Methods HIV-1-infected persons who underwent routine testing between July 2019 and May 2020 were the target population of the study. According to whether, at the time of enrollment, their CD4+ T cells reached 500 cells/μL after antiretroviral therapy(ART), HIV-1-infected persons were divided into two groups, 76 in the deficiency group and 61 in the immune recovery group. In addition, 22 people who were not exposed to HIV-1, and who were tested negative for HIV-1 antibody were selected as the control group. For the three groups of subjects, tests of the T cell subsets were conducted. A total of 77 HIV-1-infected persons, with 44 from the deficiency group and 33 from the recovery group, were examined for HIV-1 DNA reservoir.The deficiency group and the recovery group were followed up 6 months later and the CD4+ T cell test results of 133 blood samples were collected, with 74 from the deficiency group and 59 from the recovery group. Results The proportions of activated CD4+ and CD8+ T cells of the deficiency group were higher than those of the recovery group and the control group. The proportions of senescent CD4+ and CD8+ T cells in the deficiency group were comparable to those of the recovery group, which were higher than those of the control group, showing significant differences only in senescent CD8+ T cells, and no significant difference in senescent CD4+ T cells. The deficiency group expressed higher levels of effector memory CD4+ T and CD8+ T cells than the control group did, and the recovery group only expressed a higher level of effect memory CD8+ T cells. Both the deficiency group and the recovery group showed lower levels of central memory CD4+T and CD8+ T cells than the control group did, and the recovery group had an ev

关 键 词：HIV-1 T淋巴细胞 免疫激活 HIV DNA 

分 类 号：R512.91[医药卫生—内科学]