AIDS患者高效抗反转录病毒治疗后25-羟基维生素D水平与T细胞亚群含量及病毒载量的关系

Relationship between 25 hydroxyvitamin D level and T cell subsets and viral load after highly active antiretroviral therapy in AIDS patients

目的探讨AIDS患者行高效抗反转录病毒治疗(highly active antiretroviral therapy, HAART)后25-羟基维生素D水平与T细胞亚群含量、病毒载量的关系。方法选取2017年6月—2019年12月在本院诊治的128例AIDS患者,测定外周血中25-羟基维生素D、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞以及HIV RNA水平,并分析相关性。结果 128例AIDS患者治疗后25-羟基维生素D、CD3^(+)T细胞、CD4^(+)T细胞水平及CD4/CD8比值均升高,CD8^(+)T细胞、HIV RNA水平降低,与治疗前相比差异均有统计学意义(P均<0.05)。不同25-羟基维生素D水平的AIDS患者中,25-羟基维生素D≥30 ng/ml组CD3^(+)T细胞、CD4^(+)T细胞水平以及CD4/CD8比值升高,CD8^(+)T细胞、HIV RNA水平降低,与<30 ng/ml组相比差异均有统计学意义(P均<0.05)。不同CD4^(+)T细胞水平的AIDS患者中,CD4^(+)T细胞≥500个/μl组25-羟基维生素D、CD3^(+)T细胞水平以及CD4/CD8比值升高,CD8^(+)T细胞、HIV RNA水平降低,与<500个/μl组相比,差异均有统计学意义(P均<0.05)。不同HIV RNA水平的AIDS患者中,HIV RNA <400拷贝/ml组25-羟基维生素D、CD3^(+)T细胞、CD4^(+)T细胞水平以及CD4/CD8比值升高,CD8^(+)T细胞水平降低,与≥400拷贝/ml组相比差异均有统计学意义(P均<0.05)。治疗后25-羟基维生素D水平与CD3^(+)T细胞(r=0.547,P=0.008)、CD4^(+)T细胞水平(r=0.821,P=0.000)及CD4/CD8比值(r=0.630,P=0.005)呈正相关,与CD8^(+)T细胞(r=-0.295,P=0.009)、HIV RNA水平(r=-0.460,P=0.001)呈负相关。治疗后HIV RNA水平与CD3^(+)T细胞(r=-0.702,P=0.004)、CD4^(+)T细胞水平(r=-0.681,P=0.006)及CD4/CD8比值(r=-0.729,P=0.007)呈负相关,与CD8^(+)T细胞水平呈正相关(r=0.392,P=0.008)。结论 AIDS患者行HAART后,25-羟基维生素D水平与CD3^(+)T细胞、CD4^(+)T细胞水平及CD4/CD8呈正相关,与CD8^(+)T细胞、HIV RNA水平呈负相关。

Objective To investigate the relationship between 25 hydroxyvitamin D level and T cell subsets and viral load after highly active antiretroviral therapy(HAART) in AIDS patients. Methods A total of 128 AIDS patients who were diagnosed and treated in our hospital from June 2017 to December 2019 were selected. The levels of 25 hydroxyvitamin D, CD3^(+) T cell, CD4^(+) T cell, CD8^(+) T cell and HIV RNA in peripheral blood were determined, and the correlation was analyzed. Results After therapy, the levels of 25 hydroxyvitamin D, CD3^(+) T cells, CD4^(+) T cells and the CD4/CD8 ratio were increased, while CD8^(+) T cells and HIV RNA levels were decreased in 128 AIDS patients, and the differences were statistically significant compared with those before treatment(P <0.05). For AIDS patients with different 25 hydroxyvitamin D levels, the levels of CD3^(+) T cells and CD4^(+) T cells and the CD4/CD8 ratio increased,while CD8^(+) T cells and HIV RNA levels decreased in 25 hydroxyvitamin D ≥ 30 ng/ml group. The differences were statistically significant compared with 25 hydroxyvitamin D < 30 ng/ml group(P <0.05). For AIDS patients with different CD4^(+) T cell levels, the levels of 25 hydroxyvitamin D, CD3^(+) T cells and CD4/CD8 ratio increased, while CD8^(+) T cells and HIV RNA levels decreased in CD4^(+) T cells ≥ 500 cells/μl group. The differences were statistically significant compared with CD4^(+) T cells < 500 cells/μl group(P <0.05).For AIDS patients with different HIV RNA levels, the levels of 25 hydroxyvitamin D, CD3^(+) T cells, CD4^(+) T cells and CD4/CD8 ratio compared with HIV RNA ≥ 400 copies/ml group(P <0.05). After therapy, the level of 25 hydroxyvitamin D was positively correlated with CD3^(+) T cells(r=0.547, P=0.008), CD4^(+) T cells(r=0.821, P=0.000), CD4/CD8 ratio(r=0.630, P=0.005), and negatively correlated with CD8^(+) T cells(r=-0.295, P=0.009) and HIV RNA levels(r=-0.460, P=0.001). After therapy, the level of HIV RNA was negatively correlated with CD3^(+) T cells(r=-0.702, P=0.004), CD4^(+) T cells(r=-0.681, P=0.006), CD4/CD8 ratio(r=-0.729, P=0.007),and positively correlated with CD8^(+) T cells(r=0.392, P=0.008). Conclusions After HAART treatment, 25 hydroxyvitamin D level is positively correlated with CD3^(+) T cells, CD4^(+) T cells, CD4/CD8 ratio, and negatively correlated with CD8^(+) T cells and HIV RNA levels in AIDS patients.