血浆可溶性CD14在HIV-1感染者HAART中的变化和意义

Changes and significance of plasma sCD14 levels in HIV-1 infected patients receiving highly active anti-retrovirus treatment

目的观察血浆可溶性白细胞分化抗原14(sCD14)在艾滋病病毒1型(HIV-1)感染者联合高效抗反转录病毒治疗(HAART)过程中表达水平的变化,探讨HAART过程中血浆sCD14的变化规律及意义。方法以26例HIV-1感染者为研究对象,20名健康献血者为对照。用酶联免疫吸附试验(ELISA)检测健康对照组和HIV-1感染者HAART前(基线)和治疗后12、24、36及48周的血浆sCD14水平,分析sCD14表达水平变化及其与病毒学、免疫学应答的关系。结果 26例HIV-1感染者与20例对照组年龄及性别比较差异无统计学意义(t=1.813,P=0.07;χ~2=0.001,P=0.971)。HIV-1感染组基线血浆sCD14水平为(4.72±2.84)×10~6pg/mL,明显高于对照组(0.59±0.32)×10~6pg/mL(t=6.468,P<0.001),且治疗后呈明显下降趋势(F=25.975,P<0.001)。HIV-1感染组血浆sCD14在治疗12周时达(5.92±5.27)×10~6 pg/mL,与基线比较差异无统计学意义(t=1.026,P=0.315);治疗24周后迅速下降至(0.44±0.35)×10~6pg/mL,明显低于基线(t=-7.630,P<0.001),并接近对照组水平(t=1.436,P=0.158);随后血浆sCD14维持低水平,36周及48周时分别为(0.52±0.25)×10~6 pg/mL和(0.60±0.36)×10~6pg/mL,与24周及对照组比较差异均无统计学意义(t=0.825,P=0.417;t=1.558,P=0.132;t=0.863,P=0.393;t=1.80,P=0.858)。治疗24周血浆sCD14变化与Th/Ts比值变化呈负相关(r=-0.477,P=0.013),48周时血浆sCD14变化与HIV-1RNA变化呈正相关(r=0.428,P=0.029)。结论血浆sCD14在HIV-1感染者中上升,经过有效HAART后下降,有望成为HAART疗效判断的指标。

Objective To study the changes of the expression level of plasma soluble leukocyte differentiation antigen 14（sCD14）in HIV-1infected patients receiving HAART,and explore the changing paradigm and its significance of plasma sCD14 during HAART.Methods 26HIV-1infected individuals were recruited as study subjects,and 20 healthy blood donors as controls.ELISA was applied to assay the plasma sCD14 levels prior to HAART（baseline）,at 12,24,36 and 48 weeks after HAART,so as to investigate the changes in sCD14 expression level and their association with virological and immunological responses.Results There were no significant differences between the study group and the control group in age and gender ratio（t=1.813,P=0.07;χ~2=0.001,P=0.971）.The baseline plasma sCD14 level of the study group was（4.72±2.84）×10~6pg/mL,significantly higher than that（0.59±0.32）×10~6 pg/mL）of the control group（t=6.468,P0.001）,and presented a significant decreasing trend during HAART（F=25.975,P0.001）.As for the study group,the plasma sCD14 level slightly elevated to（5.92±5.27）×10~6pg/mL at 12 weeks after HAART,and drastically decreased to（0.44±0.35）×10~6 pg/mL at 24 weeks after HAART,significantly lower than the baseline（t=-7.630,P0.001）and close to the level of the control group（t=1.436,P=0.158）.At 36 weeks and 48 weeks after HAART,the plasma sCD14 maintained at a low level of（0.52±0.25）×10~6pg/mL and（0.60±0.36）×10~6pg/mL respectively,and showed no statistical difference from that of the24 th week and the control group（t=0.825,P=0.417;t=1.558,P=0.132;t=0.863,P=0.393;t=1.80,P=0.858）.The change in plasma sCD14 of the study group presented a negative correlation with the change in Th/Ts ratio（r=-0.477,P=0.013）at 24 weeks after HAART,and exhibited a positive correlation with the change in HIV viral load at 48 weeks after HAART（r=0.428,P=0.029）.Conclusion The plasma sCD14,rising in the HIV-1 infected patients and decreasing to normal levels after effective HAART,is expected to be an index for assessing the efficacy of HAART.