大连市HIV感染者/艾滋病患者在抗病毒治疗过程中病毒载量及细胞免疫指标变化的相关性分析

Correlation between viral load and cellular immune indexes during antiviral therapy among HIV/AIDS patients in Dalian

目的研究大连市HIV感染者/艾滋病患者抗病毒治疗过程中,HIV病毒载量和细胞免疫指标的变化情况。方法选取2013年开始抗病毒治疗,治疗时间满一年的HIV/AIDS 60例,分别在进行抗病毒治疗过程中的0、6、12月用全自动病毒载量分析仪(COBAS AmpliPrep/COBAS TaqMan)检测HIV病毒载量,同时用流式细胞计数仪(FACSCalibur)检测CD4^+和CD8+T淋巴细胞数。结果60例HIV/AIDS中治疗前仅有9例患者有检测数据,都是高病毒载量(VL>1 000),在治疗6个月后,病毒载量抑制比例为73.33%(44/60)、治疗12个月后,载量抑制比为81.67%(49/60)。两组治疗后比治疗前病毒载量抑制比显著升高(Z=12.85,P<0.001;Z=16.35,P<0.001)。随着治疗时间的推移,CD4^+T淋巴细胞数和CD4^+/CD8^+比值都有所上升,差异有显著性(F=72.73,P<0.001;F=53.83,P<0.001)。病毒载量越低,T淋巴细胞数及CD4^+/CD8^+比值越高,呈负相关,有显著性差异(F=21.66,P<0.001;F=8.53,P<0.001)。结论抗病毒治疗有助于提高CD4^+T淋巴细胞数,改善HIV/AIDS免疫状态。细胞免疫指标与病毒载量的相关性呈负相关。

Objective To research the changes of viral load vs cellular immune indexes of HIV/AIDS patients in Dalian during antiviral therapy.Methods Sixty HIV/AIDS patients who received antiviral therapy for at least one year since 2013 were included.HIV viral loads were detected at Month 0,Month 6,Month 12 of antiviral treatment by using automatic virus load analyzer（COBAS AmpliPrep/COBAS TaqMan）,while the levels of CD4^＋T and CD8^＋T were detected with FACS Calibur.Results Only nine cases had detection data before treatment with high viral loads of VL〉1 000.After 6months of treatment,the inhibition ratio of viral load was 73.33%（44/60）,and increased to 81.67%（49/60）after 12 months of treatment,both significantly different from that before treatment（P〈0.001）.Along with the treatment time,the level of CD4＋T and CD4^＋/CD8^＋ratio increased significantly（P〈0.001）.The lymphocyte count was negatively correlated with viral load negatively（F=21.66,P〈0.001;F=8.53,P〈0.001）.Conclusion Antiviral therapy is helpful to improve the level of CD4^＋T and the immune system of HIV/AIDS patients.Cellular immune index is negatively correlated with viral load.