HIV-1 DNA影响因素及临床价值分析  

Analysis of influential factors and clinical value of HIV-1 DNA

作　　者：韩莹 郑梅 韩金育 陈瑾 孟欢 李昀晖 梁静 陈媛 王雅杰 Han Ying;Zheng Mei;Han Jinyu;Chen Jin;Meng Huan;Li Yunhui;Liang Jing;Chen Yuan;Wang Yajie(Department of Clinical Laboratory,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院检验科,北京100015

出　　处：《中华实验和临床病毒学杂志》2023年第2期168-172,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：吴阶平医学基金会临床科研专项(320.6750.2020-08-35)。

摘　　要：目的探讨HIV-1 DNA的影响因素及其临床价值。方法选取304例HIV感染/艾滋病患者,分析HIV-1 DNA与CD4^(+)T细胞计数、CD4/CD8、HIV病毒载量、亚型之间的关系,以此探讨HIV-1 DNA的影响因素及临床应用价值。结果不同CD4^(+)T细胞水平组HIV-1 DNA载量不存在统计学差异(Z=1.194,P>0.05)。CD4/CD8≤0.5组HIV-1 DNA载量高于CD4/CD8>0.5组(Z=-2.788,P<0.01)。HIV病毒载量>100拷贝/ml组HIV-1 DNA载量高于≤100拷贝/ml组(Z=-2.953,P<0.01)。确诊时CD4^(+)T细胞计数≤200(细胞/μl)组HIV-1 DNA载量高于CD4^(+)T细胞计数>200(细胞/μl)组(Z=-2.175,P<0.05)。确诊时CD4/CD8≤0.2组患者HIV-1 DNA载量虽高于CD4/CD8介于0.2~0.5之间组,但两组之间比较没有统计学差异(Z=-0.893,P>0.05)。两组HIV-1 DNA载量均高于CD4/CD8≥0.5组(Z=-2.568,Z=-1.960,P<0.05)。确诊时HIV病毒载量>100000拷贝/ml组HIV-1 DNA载量高于HIV病毒载量≤100000拷贝/ml组(Z=-3.520,P<0.001)。CRF01_AE组HIV-1 DNA载量高于非CRF01_AE组,差异存在统计学意义(Z=-2.848,P<0.01)。CD4/CD8为HIV-1 DNA浓度高于500拷贝/ml的保护性因素(OR=0.214(95%CI:0.056~0.822,P<0.05)。结论CD4^(+)T淋巴细胞计数、CD4/CD8、病毒载量及亚型是影响HIV-1 DNA水平的因素,同时HIV-1 DNA可能对于免疫状态评估、疾病进程判断具有辅助作用。Objective To explore the influencing factors of HIV-1 DNA and its clinical value.Methods The relationship between HIV-1 DNA and CD4^(+)T cell count,CD4/CD8,HIV viral load and subtype was analyzed in 304 patients with HIV/AIDS in order to explore the factors affecting HIV-1 DNA and the value of clinical application.Results There was no statistically significant difference in HIV-1 DNA levels between the different CD4^(+)T cell level groups(Z=1.194,P>0.05).HIV-1 DNA levels were higher in the CD4/CD8≤0.5 group than in the CD4/CD8>0.5 group(Z=-2.788,P<0.01).HIV-1 DNA levels were higher in the HIV viral load>100 copies/ml group than in the≤100 copies/ml group(Z=-2.953,P<0.01).HIV-1 DNA levels were higher in those with CD4^(+)T cell counts≤200 at diagnosis than in those with CD4^(+)T cell counts>200 at diagnosis(Z=-2.175,P<0.05).HIV-1 DNA levels were higher in patients with CD4/CD8≤0.2 at diagnosis than in those with CD4/CD8 between 0.2 and 0.5,but there was no significant difference between the two groups(Z=-0.893,P>0.05).HIV-1 DNA levels were higher in both groups than in the CD4/CD8≥0.5 group(Z=-2.568,Z=-1.960,P<0.05).Higher HIV-1 DNA levels were found in people with an HIV viral load>100,000 copies/ml at diagnosis than in people with an HIV viral load≤100,000 copies/ml at diagnosis(Z=-3.520,P<0.001).The level of HIV-1 DNA was higher in the CRF01_AE group than in the non-CRF01_AE group,and the difference was statistically significant(Z=-2.848,P<0.01).CD4/CD8 seemed to be a protective factor for HIV-1 DNA>500 copies/ml.(OR=0.214(95%CI:0.056~0.822,P<0.05)Conclusion CD4^(+)T lymphocyte count,CD4/CD8,viral load and subtype are factors that influence HIV-1 DNA levels,while HIV-1 DNA may be informative for immune status assessment and disease progression determination.

关 键 词：艾滋病 HIV-1 DNA HIV储存库 CD4^(+)T淋巴细胞 HIV病毒载量 

分 类 号：R512.91[医药卫生—内科学]