CD4^+/CD8^+T细胞比值在HIV-1母婴传播早期诊断的应用

Application of CD4^+/CD8^+ T cell ratio in the early diagnosis of mother-to-child HIV-1 transmission

目的应用CD4+/CD8+T细胞(CD4/CD8)比值对母婴传播婴幼儿人类免疫缺陷病毒(HIV)感染进行早期诊断,为临床应用提供依据。方法对2011-2013年HIV阳性孕妇的115例3~11个月龄婴幼儿收集抗凝全血进行CD4+T细胞和HIV-1DNA检测。结果 115例婴幼儿中,检出HIV-1DNA 5例,检出率4.34%,且CD4+/CD8+T细胞比值均<1.0。115例中CD4+%均>25%。在110例HIV-1DNA阴性中有2例CD4+T细胞绝对数<1 500细胞/μl。5例HIV-1DNA阳性中1例CD4+T细胞绝对数<1 500细胞/μl,4例CD4+T细胞绝对数>1 500细胞/μl。结论婴幼儿的CD4/CD8比值<1.0是诊断发生母婴传播的有效早期诊断方法。

Objective To confirm the role of CD4 ＋ /CD8 ＋ T cell（ CD4 /CD8） ratio in the early diagnosis of infant human immunodeficiency virus（ HIV） infection via mother-to-child transmission so as to provide a basis for clinical application.Methods The anticoagulated whole blood samples were collected from 115 infants aged 3-11 months and born to HIV-positive mothers during 2011 through 2013,and then CD4＋T cells and HIV-1 DNA were detected. Results Of the 115 infants,5cases were positive for HIV-1 DNA,with the positive rate of 4. 34%. Analysis of the CD4＋/CD8＋cell ratio got a consistent result with the HIV-1 DNA detection,with the ratio less than 1. 0 for the 5 positive cases. The percentages of CD4＋T cells were all above 25% for the 115 cases. Among the 110 HIV-1 DNA-negative infants,the absolute numbers of CD4＋T cells of 2 cases were 〈1,500 cells /μl blood,while among the 5 HIV-1 DNA-positive infants,the absolute number of CD4＋T cells of 1case was 〈1,500 cells /μl blood and those of 4 cases were 〉1,500 cells /μl blood. Conclusions The CD4＋/CD8＋cell ratio less than 1. 0 is a reliable indicator in the early diagnosis of infant HIV infection via mother-to-child transmission.