HIV感染者HAART后EBV变化的研究

Study on Changes of Epstein-Barr in HIV Infected Patients after Highly Active Antiretroviral Therapy

目的了解河南地区HIV感染者EBV再活化的基本状况,以及接受HAART对HIV感染者EBV再活化的影响。方法应用巢式PCR技术检测73例(HIV感染组)HIV感染者及80例健康人(健康对照组)PBMCs中EBV DNA片段。检测HIV感染者CD4+T淋巴细胞计数及血浆HIVRNA含量。结果①HIV感染组和健康对照组PBMCs中EBV DNA检出的频率分别是26/73(35.6%)和4/80(5.0%)。HIV感染组显著高于健康对照组。(χ2=22.698,P<0.01)。②将73例HIV感染者,根据HAART后血浆HIVRNA含量进行分组:A组:HIVRNA含量>1000copies/ml;B组:HIVRNA含量小于最低检出限。A组和B组患者PBMCs中EBV DNA检出的频率分别是15/25(60.0%)和11/48(22.9%)。A组显著高于B组。(χ2=9.858,P=0.002<0.05)。③比较A组和B组HIV感染者CD4+T淋巴细胞计数的平均值:A组:(147.32±118.58)cell/μl,B组:(231.56±109.79)cell/μl,A组显著低于B组(t=3.024,P=0.003<0.05)。结论HIV感染者EBV再活化率显著高于健康人群。接受有效的HAART治疗的HIV感染者EBV再活化明显降低,这种降低可能与CD4+T淋巴细胞计数较高有关。

Objective To know the state of EBV reactivation in HIV - infected patients and the influence of highly active antiretroviral therapy（ HAART）. Methods EBV DNA fragment was amplified in peripheral blood monouclear cell （PBMCS） in 73 HIV - infected patients （ HIV - infected group） and 80 health people（ control group） with nest PCR. CD4 ＋ T cell count and plasma HIV viral load of HIV - infected patients were detected. Results The frequency of EBV DNA detection,in PB- MCs of HIV -infected patients and control group, were 26/73 （35.6%）and 4/80（5.0% ）, respectively. The frequency of EBV DNA detection in HIV - infected group was significantly higher than that in control group. （ X^2 = 9. 858, P = 0. 002 〈 0. 05） . The frequency of EBV DNA detection in group A and group B were 15/25（60.0% ） and 11/48（22. 9% ）, respectively. The frequency in group A was significantly higher than that in group B（X2=9. 858, P = 0. 002 〈 0. 05）. The mean value of CD4 ＋ T cell count in group D and in group E were （ 147.32 ± 118.58 ） cell/μl and （ 231.56 ±109.79 ） cell/μl,respectively. The mean value of CD4 ＋ T cell count in group A was significantly lower than that in group B （t = 3. 024 ,P = 0. 003 〈 0.05 ）. Conclusion The prevalence of EBV reactivation in HIV -infected patients was also higher than that in healthy people. EBV reactivation significantly decreased in HIV infected patients who received effective HAART,and the reduction of EBV reactivation was possibly associated with the increase of CD4 ＋ T cell count in HIV -infected patients.