外周血CD3CD38^+T淋巴细胞水平与HBV合并HIV患者病毒载量水平的相关性分析

Correlation between peripheral blood CD3CD38^+T lymphocytes and viral load of HBV patients complicated with HIV

目的探究外周血CD3CD38^+T淋巴细胞水平与乙型肝炎病毒(HBV)合并人类免疫缺陷病毒(HIV)患者病毒载量的相关性。方法选择2015年2月-2019年10月南阳医学高等专科学校第一附属医院收治的251例HIV感染患者及同期于医院查体的100名健康成人作为研究对象,根据HBV感染情况将患者分为单纯HIV感染组(144例)及HBV/HIV共感染组(107例),根据CD4^+水平将HBV/HIV共感染组分为无症状HIV感染期(38例)及艾滋病(AIDS)期(69例)两个亚组,测定HBV-DNA、HIV-RNA载量及外周血CD3、CD4^+、CD8^+、CD4^+/CD8^+、CD3CD38^+T淋巴细胞情况。结果与对照组比较,单纯HIV感染组及HBV/HIV共感染组患者CD3CD38^+、CD8^+T淋巴细胞亚群水平升高(P<0.05),CD3、CD4^+、CD4^+/CD8^+降低(P<0.05),HBV/HIV共感染组患者升高或降低幅度高于单纯HIV感染组患者(P<0.05);HBV/HIV共感染组患者HIV-RNA载量高于单纯HIV感染组患者(P<0.05);AIDS期组患者CD3、CD4^+、CD4^+/CD8^+等指标低于无症状HIV感染期组(P<0.05),CD8^+T淋巴细胞亚群计数、CD3CD38^+T淋巴细胞亚群比例及HIV-RNA载量、HBV-DNA载量均高于无症状HIV感染期组(P<0.05);在无症状HIV感染期亚组中,HIV-RNA载量与CD4^+、CD4^+/CD8^+呈负相关,与CD3CD38^+呈正相关(P<0.05);在AIDS期组亚组中,HBV-DNA载量、HIV-RNA载量与CD4^+、CD4^+/CD8^+呈负相关(P<0.05),与CD3CD38^+等呈正相关(P<0.05)。结论HIV/HBV共感染患者可存在T淋巴细胞活化,CD3CD38^+T淋巴细胞亚群比例可一定程度反映HIV/HBV共感染患者病情。

OBJECTIVE To explore the correlation between the levels of peripheral blood CD3CD38^+T lymphocytes and the viral load of the hepatitis B virus(HBV)patients complicated with human immunodeficiency virus(HIV).METHODS A total of 251patients with HIV infection and 100healthy adults who received physical examination in the First Affiliated Hospital of Nanyang Medical College from Feb.2015to Oct.2019were recruited as the study objects,the patients were divided into the simple HIV infection group with 144cases and the HBV/HIV infection group with 107cases according to the status of HBV infection.The patients with HBV/HIV infection were divided into the asymptomatic HIV infection subgroup with 38cases and the acquired immune deficiency syndrome(AIDS)subgroup with 69cases according to the CD4^+level.The HBV-DNA and HIV-RNA loads as well as the levels of peripheral blood CD3,CD4^+,CD8^+,CD4^+/CD8^+and CD3CD38^+T were determined.RESULTS The levels of CD3CD38^+and CD8^+T lymphocytes of the simple HIV infection group and the HBV/HIV infection group were significently higher than those of the control group(P<0.05),the levels of CD3,CD4^+and CD4^+/CD8^+of the simple HIV infection group and the HBV/HIV infection group were significently lower than those of the control group(P<0.05);the levels of CD3,CD4^+and CD4^+/CD8^+were elevated or reduced more significently in the HBV/HIV infection group than in the simple HIV infection group(P<0.05).The HIV-DNA load of the HBV/HIV infection group was significently higher than that of the simple HIV infection group(P<0.05).The levels of CD3,CD4^+and CD4^+/CD8^+of the AIDS subgroup were significently lower than those of the asymptomatic HIV infection group(P<0.05);the CD8^+T lymphocyte level,percentage of CD3CD38^+T lymphocyte,HIV-RNA load and HBV-DNA load of the AIDS subgroup were significently higher than those of the asymptomatic HIV infection subgroup(P<0.05).In the asymptomatic HIV infection subgroup,the HIV-RNA load was negatively correlated with CD4^+and CD4^+/CD8^+but was positively correlated with CD3CD38^+(P<0.05).In the AIDS subgroup,the HBV-DNA load and HIV-RNA load were negatively correlated with CD4^+and CD4^+/CD8^+(P<0.05)but were positively correlated with CD3CD38^+(P<0.05).CONCLUSION The patients with coinfection of HIV and HBV may have activated T lymphocyte,and the percentage of CD3CD38^+T lymphocyte subset may reflect the illness condition of the patients with coinfection of HIV and HBV infection.