摘要
目的:了解HIV感染者中人巨细胞病毒( human cytomegalovirus, HCMV)糖蛋白N ( glycoprotein N, gN)的型别分布;探讨HCMV-HIV共感染对患者疾病进程的影响及不同gN基因型感染与获得性免疫缺陷综合征( acquired immuno-deficiency syndrome,AIDS)发病和相关死亡的关系。方法对359例HIV感染者进行HCMV pp65抗原血症检测,利用HCMV gN(UL73)基因巢式PCR扩增HCMV活动性感染患者全血DNA,限制性核酸内切酶MboⅠ、ScaⅠ和SalⅠ对巢式PCR产物进行限制性片段长度多态性分析( restricted fragment length polymorphism analysis, RFLP),队列随访研究不同型别HCMV感染与AIDS患者发病和死亡的关系。结果 HCMV pp65抗原血症检测发现,359例HIV感染者中HCMV活动性感染患者28例,对其中20例HCMV活动性感染患者的全血DNA样本进行PCR-RFLP分析,结果表明,HIV感染患者中HCMV gN基因型分布如下:gN-3a,4/20(20%);gN-1,4/20(20%);gN-4b,1/20(5%);gN-4d,1/20(5%);混合感染,10/20(50%);在随访期内,HCMV UL73基因阳性的HIV感染者更易转变为AIDS患者(RR=9.78),且gN-1和gN-4型感染者发病和相关死亡风险是其他基因型的4.6倍(P<0.05)。结论 HCMV活动性感染可能会加速HIV感染者疾病进程,其中以gN-1和gN-4型HCMV活动性感染相对危险度最高。
Objective To analyze the distribution of various genotypes of human cytomegalovirus glycoprotein N ( HCMV gN) in patients with HIV infection; to investigate the effects of HCMV-HIV co-in-fection on disease progression and the relationships between HCMV gN genotypes and disease progression. Methods Patients with active HCMV infection were screened out from 359 patients with HIV infection by using the pp65 antigenemia assay.The genes encoding HCMV gN ( UL73 ) were amplified by nested PCR ( nPCR) .The amplicons were digested by restriction enzymes including MboⅠ, ScaⅠ and SalⅠ.Then, the restricted fragment length polymorphisms were further analyzed on 4%agarose gel.The relationships be-tween HCMV genotypes and the morbidity and mortality of acquired immune deficiency syndrome ( AIDS ) were investigated via a prospective study.Results Among the 359 patients with HIV infection, 28 subjects were positive for the HCMV pp65 antigenemia assay.The HCMV gN genotypes in 20 patients with active HCMV infection were distributed as: gN-3a (4/20, 20%), gN-1 (4/20, 20%), gN-4d (1/20, 5%), gN-4b (1/20, 5%) and mixed infection (10/20, 50%).Patients with HCMV-HIV co-infection were more likely to develop AIDS during the follow-up period (RR=9.78).Patients harboring HCMV gN-1 and gN-4 genotypes would seem likely to have 4.6 times of chance leading to AIDS-associated death than those harbo-ring other HCMV gN genotypes.Conclusion HCMV infection ( especially gN-1 and gN-4 genotypes) might accelerate the progression of HIV infection.
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2015年第4期258-264,共7页
Chinese Journal of Microbiology and Immunology
基金
国家自然科学基金面上项目(30872253)
安徽省科技厅科技攻关项目(08010302179)