摘要
目的分析长期接受抗逆转录病毒治疗(ART)病毒抑制的慢性艾滋病病毒(HIV)感染者的CD8+T淋巴细胞(简称CD8细胞)计数与HIV-1DNA水平的相关性。方法以2020年9月至2021年9月就诊于广西南宁市第四人民医院接受ART治疗7年且HIV-1 RNA低于50拷贝/mL的60例18~65岁HIV-1感染者为研究对象,根据研究对象检查的HIV DNA定量结果进行分组,HIV-1DNA≥100 copies/10^(6)外周血单个核细胞(PBMCs)的高HIV-1DNA水平组38例;HIV-1DNA<100 copies/10^(6) PBMCs的低HIV-1DNA水平组22例。比较两组一般资料及ART的基线信息;比较两组7年内各个随访点CD8细胞计数及CD4/CD8比值的差异性;采用单因素logistic回归分析各随访点CD8细胞计数、CD4/CD8比值与ART7年后HIV-1DNA水平是否大于100 copies/10^(6) PBMCs的相关性;并利用广义估计方程(GEE)对各随访点的CD8细胞计数、CD4/CD8比值与7年后HIV-1DNA水平进行多元回归分析。结果两组基线CD4/CD8比值、基线HIV-1RNA水平差异有统计学意义(P<0.05)。低HIV-1DNA水平组表现出较低的CD8细胞计数和较高的CD4/CD8比值。两组CD8细胞计数在第4、12、24、48、144、192、240、288、336周差异有统计学意义(P<0.05)。两组CD4/CD8水平在第0、4、12、24、48、72、96、192、240周差异有统计学意义(P<0.05)。第4、12、24、48、96、144、192、240、288、336周的CD8水平与ART7年后HIV-1DNA水平是否大于100 copies/10^(6) PBMCs相关;第0、4、12、24、48、96、192与240周的CD4/CD8水平与ART7年后HIV-1DNA水平是否大于100 copies/10^(6) PBMCs相关,差异有统计学意义(P<0.05)。经GEE分析只有CD8细胞计数与HIV-1 DNA定量值是否≥100 copies/10^(6) PBMCs差异有统计学意义(P=0.042,OR=1.002),CD8细胞计数越高,发生HIV-1DNA定量值≥100 copies/10^(6) PBMCs的概率越大。结论在接受ART治疗7年且长期病毒学抑制HIV-1感染者中CD8细胞水平越高,发生HIV-1DNA定量值≥100 copies/10^(6) PBMCs的概率越大。
Objective To analyze the correlation between the number of CD8+T lymphocytes(CD8 cells)and the level of HIV⁃1DNA in patients with chronic human immunodeficiency virus(HIV)infec⁃tion suppressed by antiretroviral therapy(ART)for a long time.Methods A total of 60 HIV⁃1 infected pa⁃tients aged 18~65 who received ART therapy for 7 years and had HIV⁃1 RNA below 50 copies/mL at the Fourth People's Hospital of Nanning,Guangxi from September 2020 to September 2021 were selected as the study sub⁃jects.The subjects were grouped according to the quantitative results of HIV DNA.38 cases were divided into a high HIV⁃1DNA level group with HIV⁃1DNA≥100 copies/106 peripheral blood mononuclear cells(PBMCs);22 cases in the low HIV⁃1DNA level group with HIV⁃1DNA<100 copies/106 PBMCs.The general data and baseline information on ART were compared between the two groups.The difference in CD8 cell count and CD4/CD8 ratio between the two groups at each follow⁃up point over 7 years was compared.Univariate logistic regression was used to analyze the correlation between CD8 cell count,CD4/CD8 ratio and HIV⁃1DNA level above 100 copies/106 PBMCs at each follow⁃up point 7 years after ART.Generalized estimation equation(GEE)was used for multiple regression analysis of CD8 cell count,CD4/CD8 ratio and HIV⁃1DNA level at each follow⁃up point 7 years after ART.Results There was a statistically significant difference(P<0.05)in the baseline CD4/CD8 ratio and baseline HIV⁃1 RNA levels between the two groups.The group with low HIV⁃1 DNA levels showed lower CD8 cell counts and higher CD4/CD8 ratios.A statistically significant difference in CD8 cell counts between the two groups was observed at weeks 4,12,24,48,144,192,240,288,and 336(P<0.05).Similarly,a statistically significant difference in CD4/CD8 levels between the two groups was found at weeks 0,4,12,24,48,72,96,192,and 240(P<0.05).CD8 levels at weeks 4,12,24,48,96,144,192,240,288,and 336 were correlated with HIV⁃1DNA levels exceeding 100 copies/106 PBMCs 7 years after ART.The CD4/CD8 levels at weeks 0,4,12,24,48,96,192,and 240 were also correlated with HIV⁃1DNA levels exceeding 100 copies/10^(6) PBMCs 7 years after ART.And the difference was statistically significant(P<0.05).According to GEE analysis,only CD8 cell count and HIV⁃1DNA>100 copies/10^(6) PBMCs showed statistical significance(P=0.042,OR=1.002).The higher the CD8 cell count,the higher the probability of HIV⁃1 DNA>100 copies/106 PBMCs.Conclusion Individuals infected with HIV⁃1 who have received ART treatment for 7 years and have long⁃term virological suppression,are more likely to develop HIV⁃1 DNA≥100 copies/106 PBMCs if they have higher levels of CD8 cells.
作者
刘燕芬
欧汝志
吴念宁
黄金萍
LIU Yanfen;OU Ruzhi;WU Nianning;HUANG Jinping(Department of Infectious Diseases,HIV/AIDS Clinical Treatment Center of Guangxi(Nanning)and The Fourth People's Hospital of Nanning,Nanning,Guangxi,China,530023)
出处
《分子诊断与治疗杂志》
2025年第8期1597-1600,1604,共5页
Journal of Molecular Diagnostics and Therapy
基金
国家科技重大专项(2017ZX10202101-001-007)
南宁市科学研究与技术开发计划重大科技专项(20203052)。
