人类免疫缺陷病毒感染临床分期与特异性抗体免疫印迹条带的相关性研究  

Correlation between clinical staging of human immunodeficiency virus infection and specific antibody immunoblot bands

作　　者：宋晓钰 商正玲 冯勤颖 黄山 周信忠 葛章文 SONG Xiaoyu;SHANG Zhengling;FENG Qinying;HUANG Shan;ZHOU Xinzhong;GE Zhangwen(Immunology Teaching and Research Section,School of Basic Medical Sciences of Guizhou Medical University,Guiyang,Guizhou,550002;Guizhou Hospital of Beijing Jishuitan Hospital,Guiyang,Guizhou,550002;Guizhou Nursing Vocational and Technical College,Guiyang,Guizhou,550002;Guizhou Provincial People′s Hospital,Guiyang,Guizhou,550000)

机构地区：[1]贵州医科大学基础医学院免疫学教研室,贵州贵阳550002 [2]北京积水潭医院贵州医院,贵州贵阳550002 [3]贵州护理职业技术学院,贵州贵阳550002 [4]贵州省人民医院,贵州贵阳550000

出　　处：《实用临床医药杂志》2024年第16期40-43,55,共5页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金资助项目(82260658);贵州省卫生健康委科学技术基金项目(gzwkj2024-201)。

摘　　要：目的分析贵州省黔东南州地区针对不同人类免疫缺陷病毒(HIV)抗原的特异性抗体在不同临床分期患者中的表达差异,探究其与获得性免疫缺陷综合征临床分期的关联。方法选取贵州黔东南州307份HIV确诊阳性血液样本,进行特异性HIV抗体免疫印迹试验,并对血液样本进行CD3^(+)CD4^(+)T细胞计数及HIV病毒载量核酸检测,将HIV感染期和艾滋病期的相关指标进行多因素回归分析。结果307例HIV感染者中,男218例,女89例,平均(48.53±16.03)岁,其特异性抗体gp160、gp120、gp41、p66、p51、p31、p55、p24和p17的构成比分别为98.7%、90.9%、92.2%、74.3%、66.4%、86.6%、3.9%、97.4%和73.9%。多因素二元Logistic回归模型分析显示,p24特异性抗体的表达是感染期的影响因素(OR=0.158,95%CI:0.032~0.768,P<0.05)。p24特异性抗体与HIV感染的临床分期有一定相关性(OR=0.217,95%CI:0.005~0.944,P<0.05)。将p24特异性表达时CD3^(+)CD4^(+)T细胞计数与病毒载量比值作为检验变量,将临床分期作为状态变量(艾滋病期=1,感染期=2)绘制受试者工作特征(ROC)曲线,曲线下面积为0.653(95%CI:0.529~0.774,P<0.05)。结论p24特异性抗体的差异表达有望提示患者处于感染期,并可能成为HIV感染患者免疫功能的预警指标。Objective To analyze the differences in the expression of specific antibodies targeting different human immunodeficiency virus(HIV)antigens among patients at different clinical stages in Qiandongnan Prefecture of Guizhou Province,and to explore their association with the clinical staging of acquired immunodeficiency syndrome.Methods A total of 307 HIV-positive blood samples from Qiandongnan of Guizhou Province were selected for specific HIV antibody immunoblotting assays.CD3^(+)CD4^(+)T cell counts andHIV viral load nucleic acid testing were performed on the blood samples.Multivariate regression analysis was conducted on relevant indicators during HIV infection and AIDS stages.Results Among the 307 HIV-infected individuals,218 were male and 89 were female,with a mean age of(48.53±16.03)years.The composition ratios of specific antibodies gp160,gp120,gp41,p66,p51,p31,p55,p24 and p17 were 98.7%,90.9%,92.2%,74.3%,66.4%,86.6%,3.9%,97.4%and 73.9%,respectively.Multivariate binary Logistic regression model analysis showed that expression of p24-specific antibodies were more likely to be judged as influencing factors in the infection stage(OR=0.158,95%CI,0.032 to 0.768,P<0.05).There was a certain correlation between p24-specific antibodies and the clinical staging of HIV infection(OR=0.217,95%CI,0.005 to 0.944,P<0.05).Using the ratio of CD3^(+)CD4^(+)T cell count to viral load when p24 was specifically expressed as the test variable,and the clinical stage as the state variable(AIDS stage=1,infection stage=2),a receiver operating characteristic(ROC)curve was plotted.The area under the curve was 0.653(95%CI,0.529 to 0.774,P<0.05).Conclusion Differential expression of p24-specific antibodies may indicate that patients are in the infection stage and could potentially serve as an early warning indicator of immune function for HIV-infected individuals.

关 键 词：获得性免疫缺陷综合征 病毒载量 人类免疫缺陷病毒 临床分期 

分 类 号：R512.91[医药卫生—内科学] R446[医药卫生—临床医学] R392.7