高效抗病毒治疗患者血浆中HIV-1 RNA与细胞中HIV-1 DNA定量研究

Quantification of HIV-1 RNA in plasma and HIV-1 DNA in cells in patients treated with highly active antiretroviral therapy

目的 探讨高效抗病毒治疗患者血浆中HIV-1RNA与细胞中HIV-1 DNA水平之间的关系及HIV-1 DNA定量在临床治疗疗效评价方面的意义。方法 选取云南省和广西壮族自治区216例接受高效抗病毒治疗的HIV感染者/AIDS患者纳入研究,收集同时期的血浆和干血斑样本,分别检测HIV-1 RNA和HIV-1 DNA载量。结果 216例患者中,58例血浆病毒载量低于检测下限(Lower than Detectable Level,LDL),有47例可检测到细胞中HIV-1 DNA,其中位数为2.15(1.55,2.83)log拷贝/10^(6)个细胞。158例可检测到血浆病毒载量,其水平为3.33(2.47,2.76)log拷贝/ml,其中149例可检测到细胞中HIV-1 DNA,其水平为2.50(1.94,2.98)log拷贝/10^(6)个细胞。血浆病毒载量与细胞中HIV-1 DNA定量值呈正相关(r=0.33,P<0.01)。结论 当接受长期抗病毒治疗患者的血浆病毒载量低于检测下限时,细胞中HIV-1 DNA的定量可以作为一种有效的辅助检测手段,为评价治疗效果提供更精准的依据。当血浆病毒载量可以检出时,细胞中HIV-1 DNA水平与血浆中病毒载量呈现正相关,提示HIV-1 DNA载量可以作为评价治疗效果的辅助指标。

Objective To explore the relationship between HIV-1 RNA in plasma and HIV-1 DNA in cells among patients treated with highly active antiretroviral therapy and to evaluate the significance of HIV-1 DNA quantification in clinical therapeutic efficacy evaluation.Methods 216 HIV/AIDS patients treated with highly active antiretroviral therapy in Yunnan province and in Guangxi Zhuang Autonomous Region were enrolled in the study.Plasma and dried blood spot samples were collected and HIV-1 RNA and HIV-1 DNA were quantified.Results Among 216 patients,the plasma viral load of 58 patients was lower than the detectable level(LDL),HIV-1 DNA was detectable in 47 of those cases with the median copies of 2.15(1.55,2.83) per 10^(6) cells.158 patients had detectable plasma viral load with the median copies of 3.33(2.47,2.76) per ml,and HIV-1 DNA was detectable in 149 patients with the median copies of 2.50(1.94,2.98) per 10^(6) cells.Plasma viral load was positively correlated with the quantity of HIV-1 DNA in cells(r=0.33,P<0.01).Conclusions When the plasma viral load of patients receiving long-term highly active antiretroviral therapy is below the detection limit,the quantification of HIV-1 DNA in cells can be an effective auxiliary detection method,which may provide a more accurate evidence for the evaluation of treatment effect.When plasma viral load is detectable,HIV-1 DNA level in cells is positively correlated with plasma viral load,suggesting that HIV DNA level could be used as an auxiliary indicator to evaluate the therapeutic effect.