杀伤细胞免疫球蛋白样受体基因与人类免疫缺陷病毒感染/艾滋病患者抗反转录病毒治疗后发生免疫重建不良的相关性

Relationship between killer cell immunoglobulin-like receptor genes and immune reconstitution failure in human immunodeficiency virus infection/acquired immunodeficiency syndrome patients after anti-retroviral therapy

目的探讨杀伤细胞免疫球蛋白样受体(KIR)基因与人类免疫缺陷病毒感染/艾滋病(HIV/AIDS)患者抗反转录病毒治疗(ART)后发生免疫重建不良的关系。方法纳入2007年5月至2019年12月就诊于广西医科大学附属武鸣医院和马山县人民医院艾滋病门诊的接受ART≥1年的HIV/AIDS患者, 并分为免疫重建不良组和免疫重建良好组。使用序列特异性聚合酶链反应(PCR-SSP)测定KIR基因型, 计算16个KIR基因型的基因型频率(PF), 统计学比较采用χ^(2)检验, 采用多因素logistic回归分析探究KIR基因与免疫重建不良的关系。结果共纳入HIV/AIDS患者102例, 其中免疫重建不良患者44例, 免疫重建良好患者58例。免疫重建不良组中KIR2DL5的PF为59.09%(26/44), 高于免疫重建良好组的36.21%(21/58), 差异有统计学意义(χ^(2)=5.27, P=0.022)。对混杂因素年龄和基线CD4+ T淋巴细胞计数进行校正后的多因素logistic回归分析显示, KIR2DL5与免疫重建不良具有相关性, KIR2DL5表达阳性可能是HIV/AIDS患者接受ART后免疫重建不良的危险因素[校正后的比值比(aOR)=2.431, 95%可信区间1.012~5.844, P=0.047]。结论 KIR2DL5表达阳性可能与HIV/AIDS患者ART后免疫重建不良有关。

Objective To analyze the relationship between killer cell immunoglobulin-like receptor(KIR)genes and immune reconstitution failure in human immunodeficiency virus infection/acquired immunodeficiency syndrome(HIV/AIDS)patients after anti-retroviral therapy(ART).Methods HIV/AIDS patients receiving ART for≥1 year who attended the AIDS outpatient clinics of Wuming Hospital of Guangxi Medical University and People′s Hospital of Mashan from May 2007 to December 2019 were included.Patients were divided into immune reconstitution failure group and full immune reconstitution group.Polymerase chain reaction with sequence specific primers(PCR-SSP)was used to detect KIR genotypes in all subjects,and the genotype frequency(PF)of 16 KIR genotypes was calculated.Statistical analysis was conducted using chi-square test.Multivariate logistic regression was used to analyze the relationship between KIR genotypes and immune reconstitution failure.Results There were 102 patients with HIV/AIDS,including 44 immunological non-responders and 58 immunological responders.The PF of KIR2DL5 in immune reconstitution failure group was 59.09%(26/44),which was higher than 36.21%(21/58)in full immune reconstitution group,and the difference was statistically significant(χ^(2)=5.27,P=0.022).Multivariate logistics regression analysis showed that KIR2DL5 was associated with immune reconstitution failure when adjusted for age and baseline CD4+T cell count.Positive expression of KIR2DL5 may be a risk factor for immune reconstitution failure(adjusted odds ratio(aOR)=2.431,95%confidence interval 1.012 to 5.844,P=0.047).Conclusions Positive expression of KIR2DL5 may be related to immune reconstitution failure in HIV/AIDS patients after ART.