HIV/AIDS患者程序死亡分子1的表达与合并机会性感染的关系

The correlation between the expression of programmed death-1 and the complication of opportunistic infection in HIV/AIDS patients

目的研究HIV/AIDS患者T淋巴细胞上程序死亡分子1(PD-1)的表达水平与合并机会性感染的关系。方法收集42例未经抗逆转录病毒治疗的HIV/AIDS患者及42例健康对照组抗凝全血,用流式细胞仪检测健康对照者和HIV/AIDS患者外周血CD4+T、CD8+T淋巴细胞上PD-1表达水平并分析其与合并机会性感染的关系。结果 HIV/AIDS合并机会性感染者CD4+T、CD8+T淋巴细胞上PD-1表达水平显著高于未合并机会性感染者(P<0.05),未合并机会性感染者显著高于健康对照者(P<0.05);HIV/AIDS患者CD4+T、CD8+T淋巴细胞上PD-1表达水平与CD4+T淋巴细胞数量显著负相关(CD4+PD-1:r=-0.371,P<0.05;CD8+PD-1:r=-0.479,P<0.05),与病毒载量显著正相关(CD4+PD-1:r=0.340,P<0.05;CD8+PD-1:r=0.360;P<0.05);当CD4+T淋巴细胞数量<200.μL-1,合并机会性感染100.00%,CD4+T、CD8+T淋巴细胞上PD-1表达水平分别为(20.30±2.48)%和(23.28±3.35)%;CD4+T淋巴细胞数量在300～400.μL-1,合并机会性感染12.50%,CD4+T、CD8+T淋巴细胞上PD-1表达水平分别为(16.11±4.17)%和(16.83±4.17)%,两者比较差异有统计学意义(P<0.05)。结论 HIV/AIDS患者T淋巴细胞上PD-1表达水平与合并机会性感染密切相关,是疾病进展的指标。

Objective To investigate the correlation between the expression of Programmed death - 1 （ PD - 1 ） on T lymphocytes and the complication of opportunistic infection in HIV/AIDS patients. Methods The anticoagulantblood samples from 42 health controls and 42 untreated HIV/AIDS patients who had been hospitalized between January 2009 and May 2012 were collected for detection of PD - 1 expression on CD4^＋ T cells and CD8^＋ T cells by flow - cytometry. The correlation of PD - 1 and complication of opportunistic infection was analyzed. Results Significant up - regulation of PD - 1 on CD4 ＋ T cell and CD8 ＋ T cell was revealed in HIV/AIDS complicated with opportunistic infection thanthose without opportunistic infection or heahhy controls （ P 〈 0. 05 ）, and so it was in those without opportunistic infection than healthy controls （ P 〈 0. 05 ）. The expression of PD - 1 was significantly negatively correlated with CIM ＋ T cellcounts （CD4 ^＋PD-I： r= -0.371, P〈0.05; CD8 ^＋PD-1： r= -0.479, P〈0.05） and positively correlated with plasma viral loads （ CD4 ^＋ PD - 1 ： r = 0. 340, P 〈 0. 05 ; CD8 ^＋ PD - 1 ： r = 0. 360, P 〈 0. 05 ）. The opportunistic infectionrate was 100% （24/24） in HIV/AIDS with CD4^＋T cell counts 〈200 cell/μL, as the PD -1 positive rates on CIM^＋T and CD8^ ＋T cells were 20. 30% and 23. 28% , respectively. The opportunistic infection rate was 12. 50% （1/8） in HIV/AIDSwith CD4 ^＋ T cell counts between 300 and 400 cell/μL, as the of PD - 1 positive rates on CIM^ ＋ T and on CD8^＋ T cells were 16. 11% and 16. 83%, respectively. Conclusion The expression of PD - 1 on lymphocytes is closely associated with thecomplication of opportunistic infection in HIV/AIDS patients, acting as a marker of disease progression.