一例重症肝病/艾滋病病例与HIV携带者和正常对照免疫学差异分析

Immunologic difference among a severe hepatopathy/AIDS case,HIV carrier and normal control

目的分析1例HIV/HBV双重感染的重症肝病/艾滋病病例与HIV/HCV双重感染病例、HIV携带者和正常对照的免疫学差异。方法随机抽取HIV携带者病例和阴性人群作为对照,应用流式细胞术分析B淋巴细胞、NK细胞、CD4+T淋巴细胞及CD8+T淋巴细胞绝对数;同时分析淋巴细胞活化标志物CD45CD56、CD56CD69、CD4CD38、CD4HLA-DR、CD8CD38、CD8HLA-DR阳性细胞百分率及淋巴细胞坏死/凋亡细胞率。结果相对于HIV/HCV双重感染、HIV携带者及正常对照,该病例各淋巴细胞亚群计数均偏低,而CD45CD56、CD4CD38、CD8CD38阳性细胞亚群均明显偏高;Spearman相关性分析结果显示,总淋巴细胞计数与CD4+T淋巴细胞计数相关性最高(r=0.778,P=0.023),CD8HLA-DR阳性亚群比率与CD4+T淋巴细胞计数相关性最高(r=-0.787,P=0.020);该病例外周血淋巴细胞死亡/凋亡指标与其它病例和正常对照相比并没有明显差别。结论 B细胞、NK细胞、T淋巴细胞各亚群计数结合淋巴细胞活化标志物可以更全面地描述HIV感染者的免疫状态。

Objective We analyzed the immunologic difference among a HIV/HBV dual infection and severe hepatopathy/AIDS case, HIV/HCV dual infection case, HIV carrier and normal control. Methods HIV carrier and normal control wererandomly selected as control group. Flow cytometer was used to analyze the absolute number of B lymphocyte, NK cell, CD4^＋Tcell and CD8^＋T cell. Simultaneously, the percentage of positive lymphocyte subtypes with different activation bio-marker asCD45CD56, CD56CD69, CD4CD38, CD4HLA-DR, CD8CD38, CD8HLA-DR and the percentage of apoptotic lymphocytewere analyzed. Results Compared with HIV/HCV dual infection case, HIV carrier and normal control, this case had lowestnumber of all lymphocyte subtypes, but had the highest percentage of CD45CD56, CD4CD38, CD8CD38 positive lymphocytesubtypes. Spearman correlation analysis showed that total lymphocyte had the highest correlation with CD4^＋T cell（r =0.778,P =0.023）, and the percentage of CD8HLA- DR positive subtype had the highest correlation with CD4^＋T cell（r =-0.787,P =0.020）. There was no significant difference between this case, other cases and normal control at the percentageof dead/ apoptosis lymphocyte. Conclusion The combination of the count of B cell, NK cell, T lymphocyte subtypes withlymphocyte activation bio-marker can help to describe immunologic characteristic overall.