HIV/AIDS病人经HAART后的免疫状况及其与肠道菌群定植抗力研究

Immunity status of the HIV/AIDS patients treated with HAART and colonization resistance of intestinal flora

目的经高效抗反转录病毒治疗（HAART）后,从微生态的角度分析不同免疫状况的艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）肠道菌群在结构和数量上的改变。方法收集经HAART后不同免疫状况的HIV/AIDS病人的粪便,提取粪便基因组脱氧核糖核酸（DNA）,应用实时荧光定量聚合酶链反应（PCR）法对6种菌属（种）进行定量。结果免疫重建不良组与免疫重建完全组病人粪便中细菌数量分别为：肠道总菌群（11.60±0.21;11.41±0.33）、拟杆菌属（10.93±0.35;10.64±0.55）、大肠杆菌（8.68±0.68;8.19±0.96）,免疫重建不良组均明显增多,差异有统计学意义。免疫重建不良组与免疫重建完全组的B/E值分别为（0.84±0.13;0.91±0.17）,差异具有统计学意义。三组B/E值均小于1,说明三组的肠道定植抗力均有明显的下降,以免疫重建不良组下降最为显著。结论不同免疫状况的HIV/AIDS病人有不同程度的肠道菌群失调,肠道定植抗力下降与肠道菌群失调的严重程度有关。

Objective To analyze from a microecological perspective the changes of structure and quantity of intestinal flora in HIV/AIDS patients with different immunity status treated with highly active antiretroviral therapy（HAART）,and study the role of the changes in the pathogenesis and development of the patients.Methods The bacterial genome DNA in feces of HIV/AIDS patients after HAART treatment with different CD4~＋T cell count was extracted and 6 bacteria by real-time fluorescent quantitative PCR were quantitatively analyzed.Results The number of fecal bacteria in the poor immune reconstitution group and complete immune reconstitution group were as follows：total intestinal flora（11.60±0.21;11.41±0.33）,bacteroides（10.93±0.35;10.64±0.55）and escherichia coli（8.68±0.68;8.19±0.96）respectively,demonstrating that there was a significant increase in the poor immune reconstruction group and the difference was statistically significant.The B/E values of the poor immune reconstitution group and the complete reconstruction group were different respectively（0.84±0.13;0.91±0.17）,with the difference statistically significant.The B/E values of the three groups were less than 1,indicating that the intestinal colonization resistance of the three groups decreased significantly, especially in the poor immune reconstitution group.Conclusion HIV/AIDS patients with different immunity status have different degrees of intestinal flora imbalance,and the decrease of intestinal colonization resistance is certainly related to the severity of intestinal flora imbalance.