艾滋病患者抗病毒过程中外周血CD8＋T细胞激活水平与CD4＋T细胞数的相关性研究

Relationship between expression of CD8＋T cell activation and CD4＋T cell count in peripheral blood of AIDS patients with highly active antiretroviral therapy

目的 探讨艾滋病患者HAART过程中CD8＋T细胞表面CD38、HLA-DR表达水平与CD4＋T细胞计数的相关性.方法 2014年1月至2015年12月绍兴市立医院就诊的57例艾滋病患者纳入研究,采集患者HAART前和治疗2年后的外周静脉血,同时采集35例健康体检者外周静脉血,经流式细胞术检测CD8＋T细胞表面CD38和HLA-DR的表达水平,分析其与CD4＋T细胞计数的相关性.结果 患者HAART前以及治疗2年后的CD4＋T细胞计数、CD8＋T细胞的CD38、HLA-DR的表达水平均显著高于健康对照组（t前=5.893、5.236和5.280,t后=6.814、4.015和4.367,P均＜0.01）.同时依据治疗前后CD4＋T细胞数的增加程度分为疗效明显组（38例）和疗效不明显组（19例）,疗效不明显组外周血中的CD8＋T细胞表面CD38、HLA-DR的表达水平较疗效明显组呈高激活状态（t=2.043和2.910,P＜0.05）.治疗前后CD4＋T细胞数与CD8＋CD38＋表达百分率呈负相关（r=-0.535和-0.338,P＜0.01）,与病毒载量呈正相关（r=0.481和0.421,P＜0.01）.HLA-DR＋ CD8＋表达频率在治疗前后与CD4＋T细胞数呈负相关（r=-0.568和-0.373,P＜0.01）,HLA-DR＋CD8＋与病毒载量在治疗前后呈正相关（r=0.469和0.343,P＜0.01）.结论 CD8＋T细胞活化水平可以反映HIV-1感染者免疫功能受损的程度,CD8＋CD38＋、HIA-DR＋CD8＋可作为评价抗病毒疗效的辅助指标.

Objective To evaluate the correlation between the expression levels of CD38 and HLA-DR on the surface of CD8＋T cell and CD4＋ T cell count during HAART in AIDS patients.Methods There were 57 AIDS patients who were treated in Shaoxing Municipal Hospital during January 2014 to December 2015 enrolled in this study.Peripheral venous blood in patients was collected before and 2 years after HAART.At the same time,peripheral venous blood in 35 healthy controls was collected.The percentage of CD38 and the expression level of HLA-DR were tested by flow cytometry,and their correlations with CD4＋T cell count were analyzed respectively.Results Before and 2 years after HAART,CD4＋T cell count,as well as CD38 and HLA-DR level of CD8＋T wereremarkably higher than those in control group （tbefore =5.893,5.236 and 5.280;tefter =6.814,4.015 and 4.367;P all ＜0.01）.Meanwhile,based on the increase level of CD4＋T cell count before and after HAART,AIDS patients were divided into obvious effect group （38 cases） and limited effect group（19 cases）.CD38 and HLA-DR level of CD8＋T in peripheral blood in limited effect group were more activated than those in obvious effect group （t=2.043 and 2.910,P＜0.05）.CD4＋T cell counts before and after the treatment were negatively related with the percentage of CD8＋CD38＋（r=-0.535 and-0.338,P＜0.01）,and were positively related with viral load （r=0.481 and 0.421,P＜0.01）.HLA-DR＋CD8＋ expression levels were negatively related with CD4＋T cell counts before and after the treatment （r=-0.568 and-0.373,P＜0.01）,and were positively related with viral load （r=0.469 and 0.343,P＜0.01）.Conclusions CD8＋T cell activation level can reflect the damage of immune function in HIV/AIDS patients.The change of CD8＋CD38＋ and HLA-DR＋CD8＋ can be used as assistant indexes for assessing HAART.