HAART对HIV/HCV合并感染者PBMCs中MxA表达水平及其对后续抗HCV疗效的影响

The effect of HAART on the expression of Mx A in PBMCs of HIV/HCV co-infected patients and its relationship with the efficacy of subsequent anti-HCV

目的纵向研究高效抗逆转录病毒治疗(HAART)对HIV单一感染者和HIV/HCV合并感染者外周血单个核细胞(PBMCs)中粘病毒抵抗蛋白Mx A mRNA表达水平的影响,分析HAART后HIV/HCV合并感染者抗HCV前基线Mx A mRNA水平是否与后续干扰素抗HCV疗效有关。方法以广州市第八人民医院收治的艾滋病患者(HIV单一感染组,HAART前CD4+T淋巴细胞<200个/mm3,42例)和HIV/HCV合并感染患者(HIV/HCV合并感染组,HAART前CD4+T淋巴细胞<200个/mm3,33例)为研究对象,并以22名健康自愿者作为对照;观察患者在抗HCV治疗前的HAART的不同时间点(0 W、4 W、12 W、24 W、48 W、72 W、96 W)PBMCs中Mx A mRNA表达水平;对比分析后继抗HCV治疗效果(有早期病毒学应答EVR,无早期病毒学应答NEVR)与Mx A mRNA表达水平的关系。结果 HIV单一感染组PBMCs中Mx A mRNA水平在HAART 4 W后下降(P<0.05),其他各时间点及与健康对照组之间差异均无统计学意义(P>0.05);HIV/HCV合并感染组PBMCs中HAART各时间点及与健康对照组之间差异均无统计学意义(P>0.05);HAART 96 W后进行抗HCV治疗,EVR组抗HCV治疗前Mx A mRNA水平较NEVR组高(P<0.05)。结论长期HAART对HIV/HCV合并感染者PBMCs中Mx A mRNA表达水平无显著影响;但HAART后抗HCV治疗前PBMCs中Mx A mRNA水平可作为HIV/HCV合并感染者抗HCV疗效的预测指标之一。

Objective To longitudinally study the effect of highly active anti-retroviral therapy（ HAART） on the expression levele of antiviral protein Mx A mRNA in peripheral blood mononuclear cells（ PBMCs） of HIV mono-infected and HIV / HCV co-infected patients and to explore the relationship between the baseline of Mx A mRNA level in HIV / HCV co-infected patients after HAART and the efficacy of subsequent anti-HCV with interferon. Methods Forty-two cases of HIV mono-infected patients and 33 cases of HIV / HCV co-infected patients were recruited as the objects of this study and 22 healthy volunteers were enrolled in the control group. All patients were collected from the Eighth People＇s Hospital of Guangzhou,whose CD4^＋T 〈200 cells / mm^3 before HAART. Before anti-HCV therapy,the levels of Mx A mRNA expression in PBMCs of HIV / HCV co-infected patients at different time points of HAART（ 0 W,4 W,12 W,24 W,48 W,72 W,96 W） were observed in this study. The relationship between the therapeutic effect of subsequent anti-HCV and Mx A mRNA was analyzed. Early viral response（ EVR） and non early viral response（ NEVR） were used to evaluate the effect of ant-HCV in this study. Results The levels of Mx A mRNA in the PBMCs of HIV mono-infected group were decreased 4 weeks after HAART（ P〈0. 05）,while there were no significant differences among the other time points of HAART in the same group and between the HIV mono-infected group and the control group（ P〉0. 05）. There were no significant differences in the HIV / HCV co-infected group in and between it and the control group among all time points（ P〉0. 05）. After the HAART of 96 weeks in anti-HCV therapy for HIV / HCV co-infected patients,the Mx A mRNA levels before anti-HCV therapy were significantly higher in the EVR group than those in the NEVR group（ P〈0. 05）. Conclusion Long-term HAART has no significant effect on the expression levels of Mx A mRNA in PBMCs of HIV / HCV co-infected patients,however,the levels of Mx A mRNA after HAART and before anti-HCV therapy can be one of the predictors of anti-HCV effect for HIV / HCV co-infected patients.