HIV-1感染者外周血增加的CD71^(+)红系细胞特点及临床意义

Characteristics and clinical significance of increased CD71^(+) erythroid cells in peripheral blood of people living with HIV-1

目的探讨HIV-1感染者外周血CD71^(+)红系细胞的特点及其与疾病进展的关系。方法通过流式细胞术检测HIV-1感染者外周血CD71^(+)红系细胞,分析其与HIV-1 RNA、CD4细胞计数、CD4/CD8细胞比值的相关性。结果入组10例健康对照(HCs)和49例HIV-1感染者,后者包括28例未接受过ART者(TNs)和21例免疫重建成功患者(CRs)。与HCs组(平均值0.69%)相比,TNs组患者CD71^(+)红系细胞频率明显升高(平均值2.79%)。CRs组患者经ART后,CD71^(+)红系细胞频率降低(平均值1.18%),但是未恢复到正常水平。TNs组患者CD71^(+)红系细胞频率与病毒载量呈显著正相关(r=0.503 4,P=0.006 3),与CD4/CD8细胞比值呈明显负相关(r=-0.464 0,P=0.012 9)。与HCs(平均值158 g/L)相比,TNs组患者外周血血红蛋白含量明显降低(平均值149 g/L);CRs组患者经ART后,血红蛋白含量升高(平均值154 g/L),并且恢复到正常水平;TNs组患者CD71^(+)红系细胞频率与血红蛋白含量呈明显负相关(r=-0.462 5,P=0.013 2)。与HCs(平均值53.84%)相比,TNs组患者CD71^(+)红系细胞活性氧(ROS)表达水平明显升高(平均值66.64%);CRs组患者经ART后,CD71^(+)红系细胞表达ROS显著降低(平均值43.82%),并且降至正常水平。结论HIV-1感染导致外周血CD71^(+)红系细胞频率升高,并且与疾病进展和血红蛋白的降低密切相关。

Objective This paper discusses the relationship between CD71^(+) erythroid cells in peripheral blood and disease progression and the characteristics of these cells in people living with HIV-1. Methods The frequencies and characteristics of CD71^(+) erythroid cells in peripheral blood of people living with HIV-1 were detected by flow cytometry,and the correlations with viral load, CD4 cell count and CD4/CD8 ratio were analyzed. Results 10 healthy controls(HCs) and 49 patients including 28 treatment na?ve patients(TNs) and 21 complete responders(CRs) who accepted successful antiretroviral therapy(ART) were enrolled in this study. Compared with HCs, TNs showed significantly increased frequencies of CD71^(+) erythroid cells(mean 0.69% vs 2.79%), and CD71^(+) erythroid cells significantly increased in TNs compared with CRs(mean 2.79% vs 1.18%). The frequencies of CD71^(+) erythroid cells of TNs were positively correlated with viral load(r=0.5034, P=0.0063), and negatively correlated with that of CD4/CD8 ratio(r=-0.4640, P=0.0129). The hemoglobin of TNs was lower than that of HCs(mean 148.9 g/L vs 157.8 g/L). The hemoglobin increased in CRs compared with that in TNs(mean 148.9 g/L vs 154.2 g/L), and the frequencies of CD71^(+) erythroid cells were negatively correlated with hemoglobin in TNs(r=-0.4625, P=0.0132). The production of ROS of CD71^(+) erythroid cells in TNs was significantly higher than that in HCs(mean 53.84% vs 66.64%). Compared with that in TNs, the production of ROS of CD71^(+) erythroid cells in CRs markedly decreased(mean 66.64% vs 43.82%). Conclusion Expansion of CD71^(+) erythroid cells in peripheral blood of people living with HIV-1 is associated with disease progression and reduced hemoglobin.