HIV/AIDS病人CD_4^+T淋巴细胞计数与HDL-C水平的相关性

Correlation of CD_4^+ T lymphocytes and HDL-C levels in HIV/AIDS patients

目的探讨未经高效抗反转录病毒治疗(HAART)的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(HIV/AIDS病人),不同CD+4T淋巴细胞(CD4细胞)水平的高密度脂蛋白胆固醇(HDL-C)的水平。方法选择未进行HAART的HIV/AIDS病人,同时检测CD4细胞计数和空腹血脂水平,比较不同CD4细胞水平的HIV/AIDS病人的血脂水平,重点观察HDL-C的变化。结果 CD4细胞计数与HDL-C水平呈正相关(P<0.01),CD4细胞计数>200/μL组的107例病人的HDL-C为(1.02±0.29)mmol/L,≤200/μL组的139例病人的HDL-C为(0.84±0.35)mmol/L,≤200/μL病人的HDL-C较>200/μL病人明显降低(P<0.01)。而CD4细胞计数在200~51/μL的病人HDL-C为(0.96±0.30)mmol/L,≤50/μL的病人HDL-C为(0.72±0.36)mmol/L,≤50/μL的HDL-C降低更明显(P<0.01)。结论 HIV感染可导致血脂异常,HAART之前的HIV/AIDS病人中,主要是HDL-C及载脂蛋白A1的降低,随着CD4细胞计数减少,HDL-C水平随之降低,心血管疾病(CVD)的危险随之升高。

Objective To explore HDL-C levels of HAART-naive human immunodeficiency virus （HIV）/ acquired immune deficiency syndrome （AIDS） patients with diverse CD4 cell counts. Methods The fasting serum lipid levels and CD4 cell counts were tested simultaneously, serum lipid levels with diverse CD4 cell counts were compared, especially HDL-C. Results CD4 cell counts were positively correlated with HDL-C levels. HDL-C of patients with CD4 cell counts〉200/μL was 1.02±0.29 mmol/L, and HDL-C of patients with CD4 cell counts ≤ 200 /μL was 0.84±0.35 mmol/L. HDL-C levels of patients with CD4 cell counts ≤ 200/μL were distinctly lower than those of patients with CD4 cell counts 〉200μL. Furthermore, HDL-C of patients with CD4 cell counts between 51 and 200μL was 0.96±0.30mmol/L, and HDL-C of patients with CD4 cell counts ≤50/μL was 0.72±0.36 mmol/ L. HDL-C of patients with CD4 cell counts≤50/μL was even lower. The statistical difference was significant（P〈 0.01）. Conclusions HIV infection leads to dyslipidemia. HDL-C and ApoA1 usually reduce before HAART. HDL C level declines and the risk of cardiovascular disease （CVD） rises with the decrease of CD4 cell counts.