HIV暴露未感染新生儿肠道菌群特征及免疫功能变化

Intestinal flora and immune function of newborns exposed to HIV but not infected

目的 分析HIV暴露未感染新生儿的肠道菌群特征及免疫指标水平。方法 选取2020年1月-2021年1月于浙江大学医学院附属杭州市西溪医院妇产科出生的HIV暴露但未感染(进行母婴阻断治疗,出生48小时内检测HIV RNA阴性)新生儿20例为母婴阻断组,另选取20名同期出生且胎龄、出生体质量等一般资料相近的健康新生儿为对照组。比较两组新生儿Apgar评分、粪便中菌群数量及免疫功能指标。结果 两组新生儿Apgar评分差异无统计学意义。与对照组比较,母婴阻断组新生儿粪便中乳酸菌科和双歧杆菌数量显著下调(P<0.05),血清中免疫球蛋白(Ig)M水平(0.98±0.22)g/L显著上调(P<0.05),CD_(4)^(+)水平(32.16±7.07)%显著下调(P<0.05)。结论 HIV暴露但未感染新生儿的粪便中乳酸菌科和双歧杆菌等益生菌的数量显著下调,其体液免疫功能虽未受到显著影响,但CD_(4)^(+)T淋巴细胞数量显著下调,细胞免疫功能受到较大影响。

OBJECTIVE To observe the characteristics of intestinal flora and immune function indexes of the newborns exposed to HIV but not infected.METHODS From Jan 2020 to Jan 2021,a total of 20 neonates who were exposed to HIV but not infected(mother-infant blocking treatment,negative for HIV RNA test within 48 hours)and were born in department of obstetrics and gynecology of Hangzhou Xixi Hospital,Affiliated to Medical College of Zhejiang University were assigned as the mother-infant blocking group,meanwhile,20 healthy neonates who had similar baseline data such as gestational age and birth weight were chosen as the control group.The Apgar score,counts of flora in stool and immune function indexes were observed and compared between the two groups of neonates.RESULTS There was no significant difference in the Apgar score between the two groups of neonates.The counts of lactic acid bacteria and Bifidobacteria in the feces were remarkably less in the mother-infant blocking group than in the control group(P<0.05).The serum immunoglobulin(Ig)M level(0.98±0.22)g/L was significantly up-regulated(P<0.05),while the CD_(4)^(+)level(32.16±7.07)%was significantly down-regulated(P<0.05).CONCLUSION The counts of feces probiotics such as lactic acid bacteria and Bifidobacteria of the neonates exposed to HIV but not infected are remarkably down-regulated,although the humoral immune function is not remarkably affected,the CD_(4)^(+)T lymphocytes counts are remarkably down-regulated,and the cellular immune function is remarkably affected.