Correlation Analysis on Total Lymphocyte Count and CD4 Count in HIV-infected Patients: A Retrospective Evaluation

CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy （HAART） and monitoring HIV/AIDS disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count （TLC） and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties （Shangcai, Queshan, Shenqiu and Weishi） were included in the study. Pearson correlation and receiver operating characteristic （ROC） were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART （P〈0.01）. An overall positive correlation was noted between TLC and CD4 count （pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001）. The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm3 could predict CD4 〈 200 cells/mm3 with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count 〈 200 cells/mm3 was a TLC ≤ 1300 cells/mm3, with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change （r=0.77, P=0.0001） at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm3. TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.

Assessing the effect of traditional Chinese medicine on CD4+ lymphocyte count of 807 HIV/AIDS cases

National Free Traditional Chinese Medicine (TCM) HIV/AIDS Treatment Program had been carried out for more than 5 years, treating 9267 cases accumulately by 2009. We report the 3-year outcome on CD4+ lymphocyte count of 807 cases of HIV/AIDS enrolled in the National Free TCM HIV/AIDS Treatment Pro- gram, the CD4+ lymphocyte count were measured every 6 month at 7 time points (0, 6, 12, 18, 24, 30, 36 month). The results showed that the overall CD4+ ly mphocyte count maintained stable at the 6th month and the 12th month, declined significantly at the 18th month, 24th month and 30th month, then elevated to the pre-treatment level at the 36th month. Patients with pre-treatment CD4+ lymphocyte count level 350/mm3 had CD4+ lymphocyte count declined significantly after all visits. In summary, combined treatment of Chinese herbal medicine and conventional therapy on HIV/AIDS suggested promising effect, but more evidences from larger, rigorous designed studies still needed to support the affirmative effect of TCM in the future.

Detection of microbial antigenic components of circulating immune complexes in HIV patients:Involvement in CD4^+ T lymphocyte count depletion

Objective:To investigate the prevalence of microbial antigenic components of circulating immune complexes amongst grades of CD4 T lymphocyte counts in HIV sero positive and seronegative participants.Methods:Polyethelene glycol(PEG-600) and buffering methods of precipitation and dissociation of immune complexes was used to generate immune solution from sera of 100 HIV sero-positive and 100 HIV sero-negative participants.These were categorized into 3 grades based on CD4 count:】 500 cell/mm,200-499 cell/mm3 and 【200 cell/mm3.The immune solutions were assayed using membrane based immunoassay and antibody titration, along side its unprocessed serum for detection of various microbial antigens and or antibodies. CD4 T cell counts were estimated using Patec Cyflow SL-3 Germany.Results:Antigenic component of immune complexes of various infectious agents was detected in 99 and 70 HIV seropositive and HIV sero-negative participants,respectively.In group A,there were 10 HIV positive participants,including 4(40.0%) had circulating immune complexes(CICs) due to Salmonella species only:1(10.0%) due to Salmonella-Plasmodium falciparum(P.falciparum),SalmonellaP. falciparum-HCV and P.falciparum antigens,respectively.In group B,45(45.4%) HIV seropositive participants with CICs had CD4 T lymphocyte count between 200-499 cells/mm^3.Out of these,20(44.4%) had CICs due to Salmonella species only:9(20%) due to Salmonella-P. falciparum.In group C,there were 44(44.4%) HIV sero-positive participants,including 3(6.8%) due to Salmonella species only:24(54.4%) due to Salmonella-P.falciparum:2(4.5%) due to P. falciparum only.Conclusions:In HIV sero-positive participants,presence of heterogeneity of Salmonella species-P.falciparum antigens was highly incriminated in CD4 count depletion but not homogeneity of malaria parasites antigens.Malaria parasites antigens only were incriminated in CD4^+ count depletion amongst HIV sero-negative participants.Before taking any decision on the management of HIV-1-positive individuals,their malaria and Salmonella paratyphi status should be assessed,but not malaria status alone.

CD4 T-Lymphocytes Count in HIV-<i>Toxoplasma gondii</i>Co-Infected Pregnant Women Undergoing a Prevention of Mother-to-Child Transmission Program

Toxoplasma gondii (T. gondii) is a parasite responsible of toxoplasmosis, a disease often asymptomatic but with serious consequences in pregnant women and immunocompromised subjects. Objective: This study aimed to investigate the impact of T. gondii infection on CD4+ T lymphocytes count in HIV-infected pregnant women. Methods: This was a cross-sectional study of pregnant women co-infected by HIV and T. gondii. The study was conducted from January to July 2016 at the Prevention of Mother-to-Child Transmission of HIV (PMTCT) sites in the Health District of Lacs in Togo. Diagnosis of HIV was performed by immuno-chromatographic methods with Determine TM HIV-1/2 and immuno-filtration with Tri-Dot HIV-1 and 2 kits. Presence of anti-toxoplasmic IgG and IgM antibodies was established via enzyme immunoassay using ELISA-BIOREX&reg;kit. Flow cytometry was used to count CD4+ T lymphocytes. Results: Our study found that of the 4599 pregnant women, 111 (2.41%) were HIV-positive. Among them, 109 (98.20%) were infected by HIV-1 and 2 (1.98%) by HIV-2. Antibodies against T. gondii were detected in 5.36% (IgM), 25% (IgG) and 3.57% (both IgM and IgG) of HIV 56 infected women. There was no significant difference between CD4 cell count in HIV (+)/T. gondii IgM (-)/IgG (-) infected pregnant women (378.8 ± 222.8 cell//μl) compared to HIV (+)/T. gondii/IgM (+) (457.3 ± 183.3 cell//μl), HIV (+)/T. gondii IgG (+) (419.4 ± 287.3 cell//μl) and HIV (+)/T. gondii IgM/IgG (+) (480.5 ± 252.4 cell/μl). Conclusion: This study showed that intracellular parasite T. gondii did not alter CD4+ T lymphocytes count in HIV/T. gondii co-infected pregnant women.

Association between the level of CD4^+T lymphocyte microRNA-155 and coronary artery disease in patients with unstable angina pectoris

Objective To study the association between the expression of microRNA-155(miRNA-155)in peripheral blood CD4^+T lymphocytes and the level of semrn interferon-7(IFN-7)concentration and the severity of coronary artery disease (CAD).Methods After coronary angiography,252patients with suspected unstable angina pectoris (UAP)were divided into the UAP group (128patients with CAD confirmed by angiography)and the control group (124patients without CAD confirmed by angiography).Fresh peripheral blood was extracted 16-24h before coronary angiography,CD4^+T lymphocytes was tested using immunomagnetic beads,the expression ofmiRNA-155was tested using quantitative PCR and the expression of IFN-7was tested using enzyme-linked immunosorbent assay (ELISA).According to the results of angiography,Gensini score of coronary artery lesions was analyzed.Furthermore,we also analysis the association between the level of miRNA-155in peripheral blood CD4^+T lymphocytes,the level of serum IFN-γand Gensini score of coronary lesion.Results The levels ofmiRNA-155(0.49±0.08vs.0.23±0.09)and IFN-7(227.58±26.01vs.141.23±17.89)in the UAP group were significantly higher than that of the control group,the difference was statistically significant.The level of miRNA-155and IFN-γwere positively correlated with Gensini score of CAD (r =0.534,r =0.713,respectively,all P <0.05).The level of miRNA-155was positively correlated with the level of IFN-γ,(r =0.686,P <0.05).Conclusions The level of miRNA-155in peripheral blood CD4^+T lymphocytes and the level of IFN-γ are closely correlated with the severity of CAD.

Viral Characteristic of HIV Infected Patients Naïf of Anti-Retroviral Therapy with CD4+ T Lymphocytes Rate Greater than 350 per Microliter of Blood in LoméTogo

Objective: To evaluate the virological status of ineligible HIV patients for anti-retroviral therapy based on the criterion of CD4+ T lymphocytes rate over than 350/μl of blood. Method: This is a prospective study which was conducted from November 2011 to July 2012 in the tropical and infectious disease department of CHU Sylvanus Olympio of Lomé. All HIV-1 infected patients whose CD4+ T lymphocytes rate was ≥350/μl of blood were retained. The count of CD4+ T lymphocytes was made by cytometer FACSCalibur? flow of BD biosciences and the determination of viral load was achieved by NASBA laboratory method of Biomérieux. Results: We have recruited 102 PLWHA aged between 19 and 58 years with a median of 35 years. Biologically, 102 patients had a T-CD4 rate between 355 and 432/μl of blood. The determination of viral load showed a very high viral replication more than 10,000 copies/ml among all patients and 28 (27.5%) patients had a viral load > 100,000 copies/ml of blood. Conclusion: Our results argue for a reconsideration of the criteria for starting antiretroviral therapy in Togo by including virological data if necessary in patients with T-CD4 rate below 500/μl of blood.

Role of CD4+ and CD8+ T Lymphocyte in the Onset of Stroke in People Living with HIV in Pointe-Noire

Objective: To determine the role of CD4+ and CD8+ T lymphocytes in the onset of stroke in people living with HIV. Methodology: This was a descriptive, cross-sectional study from January to July 2019, in the neurology department of loandjili general hospital, including any patient hospitalized for a first episode of stroke confirmed by brain scan. The study variables were: age, sex, CRP value, serum T cell CD4+, CD8+. The statistical analysis was carried out using the EPI info 7 software. Results: Twenty stroke patients were included. The relative frequency of HIV was 20%. The risk factors were potentiated by immunosuppression of CD4+ T cells. Sixty percent (60%) of the patients had a CD4+ count < 200/mm3 and the mean CD4+ count was ±191/mm3. Stroke was the predominant mechanism of injury with a frequency of 70%, the only injury mechanism of stroke in patients with CD8+ T cell count > 800/mm3 (p = 0.04). Conclusion: Risk factors are potentiated by TCD4+ lymphocyte immunosupression, also CD8+ lymphocytes of immune system activation marker are a cardiovascular risk factor for living people with HIV.

Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

AIM: To determine if efforts to improve antiretroviral therapy(ART) adherence minimizes the negative impact of depression on human immunodeficiency virus(HIV) outcomes. METHODS: A cross-sectional study of a clinic-based cohort of 158 HIV seropositive(HIV+) African Americans screened for major depressive disorder(MDD) in 2012. CD4 T lymphocyte(CD4+) counts were obtained from these individuals. Self-report on adherence to ART was determined from questionnaire administered during clinic visits. The primary outcome measure was conditional odds of having a poorer CD4+ count(< 350 cells/mm3). Association between CD4+ count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders. RESULTS: Out of 147 individuals with available CD4+ T lymphocyte data, 31% had CD4+ count < 350 cells/mm^3 and 28% reported poor ART adherence. As expected the group with > 350 cells/mm^3 CD4+ T lymphocyte endorsed significantly greater ART adherence compared to the group with < 350 cells/mm3 CD4+ T lymphocyte count(P < 0.004). Prevalence of MDD was 39.5% and 66% of individuals with MDD took antidepressants. Poor CD4+ T lymphocyte count was associated with poor ART adherence and MDD. Adjusting for ART adherence, age, sex and education, which were potential confounders, the association between MDD and poor CD4+ T lymphocyte remained significant only in the untreated MDD group.CONCLUSION: Therefore, CD4+ count could be a clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients.

Autoimmune pancreatitis characterized by predominant CD8+ Tlymphocyte infiltration

Autoimmune pancreatitis(AIP)is a rare form of pan-creatitis characterized by prominent lymphocyte inf iltration and pancreatic f ibrosis resulting in organ dysfunc-tion.The pathogenesis and pathology of AIP remain unknown.A 64-year-old Chinese man presented with symptoms and signs of bile duct obstruction diffuse enlargement of the head of pancreas,elevated IgG levels,and negative autoimmune antibody responses.A pylorus-preserving pancreatoduodenectomy was per-formed and a pancreatic tumor was suspected.Howev-er,periductal lymphoplasmacytic inf iltration and f ibrosis were found in the head of pancreas and nearby organs instead of tumor cells.Four months after surgery,the patient was readmitted because of reoccurrence ofsevere jaundice and sustained abdominal distension.Prednisone 30 mg/d was administered orally as an AIP was suspected.One and a half months later,the symp-toms of the patient disappeared,and globulin,amino-transferase and bilirubin levels decreased signif icantly.Over a 9-mo follow-up period,the dose of prednisone was gradually decreased to 10 mg/d and the patient remained in good condition.We further demonstrated dominant CD3+/CD8+ populations,CD20+ cells and a few CD4+ cells in the pancreatic parenchyma,duo-denum and gallbladder wall by immunohistochemical assay.This AIP case presented with signif icant CD8+ T lymphocyte inf iltration in the pancreas and extra-pan-creatic lesions,indicating that this cell population may be more important in mediating AIP pathogenesis than previously known and that AIP might be a poorly defined autoimmune disease with heterogeneous pathogenesis.

Sustained heavy ethanol drinking affects CD4⁺cell counts in HIV-infected patients on stavudine (d4T), lamivudine (3TC) and nevirapine (NVP) treatment regimen during 9 months follow-up period

Sustained heavy ethanol drinking is a common problem globally and ethanol is one of the most abused drugs among individuals of different socio-economic status including the HIV-infected patients on antiretroviral drugs. Ethanol is reward drug and a CNS depressant especially at high doses. The study determined the effect of sustained heavy ethanol drinking by HIV-infected patients on d4T/3TC/NVP regimen on CD4+ cell counts in Uganda using WHO AUDIT tool and chronic alcohol-use biomarkers. A case control study using repeated measures design with serial measurements model was used. The patients on stavudine (d4T) 30 mg, lamivudine (3TC) 150 mg and nevirapine (NVP) 200 mg and chronic alcohol use were recruited. A total of 41 patients (20 in alcohol group and 21 in control group) were screened for chronic alcohol use by WHO AUDIT tool and chronic alcohol use biomarkers. They were followed up for 9 months with blood sampling done at 3 months intervals. CD4+ cell count was determined using Facscalibur Flow Cytometer system. Results were then sorted by alcohol-use biomarkers (GGT, MCV and AST/ ALT ratio). Data were analysed using SAS 2003 version 9.1 statistical package with repeated measures fixed model and the means were compared using student t-test. The mean CD4+ cell counts in all the groups were lower than the reference ranges at baseline and gradually increased at 3, 6 and 9 months of follow-up. The mean CD4+ cell counts were higher in the control group as compared to the chronic alcohol use group in both WHO AUDIT tool group and chronic alcohol-use biomarkers group though there was no significant difference (p > 0.05). Chronic alcohol use slightly lowers CD4+ cell count in HIV-infected patients on d4T/3TC/NVP treatment regimen.

Factors Associated with Sample Rejection for CD4+/CD8+ T Cell Count Analyses at the Kenyatta National Hospital Comprehensive Care Center Laboratory, Kenya

Background: The appropriate time to initiate antiretroviral therapy (ART) in HIV/AIDS patients is determined by measurement of CD4+/CD8+ T cell count. The CD4/CD8+ T cell count is also useful, together with viral load, in monitoring disease progression and effectiveness treatment regimens. Several factors may contribute to sample rejection during the CD4+/CD8+ T cells count, resulting in negative effects on patient management. Objective: Evaluate the causes for CD4+CD8+ T cell count sample rejection at the Kenyatta National Hospital Comprehensive Care Center Laboratory. Method: A retrospective cross-sectional study was conducted between 2018 and 2020. Data was obtained from the “rejected samples” for PartecR FlowCyp flow cytometry file. Designed data collection sheet was used for data capture. A total of 3972 samples were submitted for CD4+/CD8+ T cell count during the study period. Causes for sample rejection were numbered 1 to 12, each representing a reason for sample rejection. Number 1 was sub-categorized into clotted, hemolyzed, short-draw and lipemic. Data was analyzed using excel, and presented using tables, graphs and pie charts. Approval to conduct the study was obtained from KNH/UoN ERC. Results: In the study period, 81/3972 (2.0%) samples were rejected. Samples submitted more than 48 hours after collection were mostly rejected. Other factors included improper collection technique, delayed testing, patient identification error and incorrect use of vacutainer. A combination of clotted samples, specimen submission more than 48 hours caused the most frequent sample rejection, followed with combination of specimen submission more than 48 hours, delayed testing and delayed specimen processing. Together, clotted samples, incorrect vacutainer and poor specimen label caused the least sample rejection. Conclusion: Sample rejection rate for CD4/CD8+ T cell count was relatively low, and multiple factors contributed to rejection. However, improved quality assurance will enable more benefit to patients who seek this test in the laboratory.

中国HIV/AIDS患者CD_4^+CD_8^+T淋巴细胞与外周血各组份间关系的研究

目的 研究艾滋病病毒 /艾滋病 (HIV/AIDS)患者CD+ 4 、CD+ 8T淋巴细胞数与外周血各组份间白细胞(WBC)、血小板 (PLT)、血红蛋白 (HGB)、粒细胞百分数 (GR % )、淋巴细胞百分数 (LY % )、LY的相关性 ,为临床治疗提供参考依据。方法 HIV/AIDS患者抗凝外周血 5 13份 ,在 6小时之内检测其血细胞分类和CD+ 4 、CD+ 8T淋巴细胞计数 ,比较CD+ 4 、CD+ 8T淋巴细胞计数与WBC、HGB、PLT、LY %、GR %和LY的相关性。结果 CD4/CD8全部倒置 ,其中CD4/CD8<1者达 94 7% ;CD+ 4 细胞数 <5 0 0 /mm3 与HGB (r=0 16 0 ,P <0 0 1)、PLT (r=- 0 0 14 ,P <0 0 1)、GR % (r=- 0 2 81,P<0 0 1)、LY % (r =0 32 1,P <0 0 1)、LY((r =0 4 94 ,P <0 0 1)相关均有非常显著的统计学意义 ;CD+ 8细胞数与WBC数 (r=0 112 ,P <0 0 5 )、HGB (r=0 131,P <0 0 1) 、GR % (r=- 0 5 2 6 ,P <0 0 1)、LY % (r=0 5 6 9,P <0 0 1)、LY (r=0 90 4 ,P <0 0 1) 相关均有显著性 ;2 0 0 /mm3 <CD+ 4 细胞数 <5 0 0 /mm3 与LY (r=0 2 79,P <0 0 1)、PLT (r=0 192 ,P <0 0 1) 相关有显著性 ,CD+ 4 细胞数 <2 0 0 /mm3 与LY (r =0 2 6 2 ,P<0 0 1)、LY % (r =0 2 79,P<0 0 1)、GR % (r =- 0 2 94 ,P<0 0 1)

脓毒症性急性肾损伤患者CD_4^+ T淋巴细胞内三磷酸腺苷水平变化及其与肾功能转归的关系

目的探讨CD_4^+T淋巴细胞内三磷酸腺苷(CD_4^+T cell-iATP)水平预测脓毒症并发急性肾损伤(AKI)患者预后的价值。方法前瞻性选择2013年7月—2014年12月于丽水市中心医院ICU、感染科及肾内科住院的脓毒症并发AKI患者69例为研究对象,分别于人组0、48、96h检测患者CD_4^+T cell-iATP水平。根据肾功能临床转归情况将患者分为肾功能完全恢复组(18例)、肾功能部分恢复组(38例)、依赖透析组(4例)和死亡组(9例)。结果各组eGFR、功能衰竭脏器数量、AKI分期及0、48h CD_4^+T cell-iATP水平比较,差异有统计学意义(P<0.05)。多分类Logistic回归分析结果显示,相对于预后不良(依赖透析或死亡),eGFR、功能衰竭脏器数量和48h CD_4^+T cell-iATP水平为肾功能完全恢复、肾功能部分恢复的影响因素(P<0.05)。ROC曲线分析显示,48h CD_4^+T cell-iATP水平预测脓毒症并发AKI患者预后的ROC曲线下面积为0.926(P<0.01),取48h CD_4^+T cell-iATP临界点为344.2μg/L时,灵敏度为92.3%,特异度为87.5%。结论 CD_4^+T cell-iATP水平低的脓毒症患者肾功能恢复良好,脓毒症患者早期CD_4^+T cell-iATP水平是肾功能转归的预测指标。

广西壮族自治区健康成年人T淋巴细胞亚群分类绝对计数及CD_4/CD_8比值调查

目的 初步建立广西壮族自治区健康人群外周静脉血CD3 、CD4、CD8T淋巴细胞绝对数值和CD4/CD8比值的参考范围。方法 用流式细胞仪 (FACSCalibur,FCS)、三色免疫荧光试剂和绝对计数管 (TnTEST/Tru COUNT) ,检测 110名广西健康成年人 (16～ 5 6岁 )静脉全血CD3 、CD4、CD8T淋巴细胞绝对数值和CD4/CD8比值 ,并观察T淋巴细胞亚群分类计数在性别、年龄和民族上的差别。结果 110名健康成年人检测结果平均值 :CD3 为5 2 4± 5 4 1,CD4为 82 3± 30 5 ,CD8为 6 0 1± 2 4 8,CD4/CD8为 1 4 9± 0 5 3。进一步分析发现 ,CD4和CD4/CD8在民族分布上 (汉族 79名、壮族 31名 )的差异有显著的统计学意义 (P <0 0 5 )。结论 这次初步建立CD3 、CD4、CD8T细胞绝对数值和CD4/CD8比值正常参考范围 ,对于指导广西的艾滋病诊断及治疗工作有重要意义。

日本血吸虫慢性感染致CD_4^+ T细胞凋亡的分子基础

目的 立足于全基因水平考察日本血吸虫慢性感染小鼠CD+4T细胞的凋亡相关基因的变化。方法 采用三色流式细胞术结合高密度寡核苷酸芯片 (Affemetrix芯片 ) ,对日本血吸虫感染 13周的小鼠脾脏中的CD+4T细胞进行凋亡观察及基因转录分析 ,获得凋亡相关基因的表达图谱。结果 日本血吸虫慢性感染小鼠CD+4T细胞的凋亡率均明显高于正常小鼠 (P <0 0 1) ;感染小鼠的CD+4T细胞中有 2 5个凋亡相关基因与正常小鼠相比有显著性差异 ,包括凋亡促进基因—生长抑制和DNA损伤 -GADD家族和肿瘤坏死因子α诱导蛋白 3,凋亡抑制基因—IAP等。结论 日本血吸虫慢性感染小鼠CD+4T细胞的凋亡可能是导致宿主免疫下调的原因之一。凋亡通路中存在复杂的凋亡促进基因和抑制基因的相互作用 ,其中肿瘤坏死因子α诱导蛋白 3可能是日本血吸虫感染诱导CD+4T细胞凋亡的特征性因子。

肺癌患者胸腔积液及外周血CD_4^+CD_(25)^+T细胞、Foxp3基因表达及意义

目的探讨CD4+CD2+5T细胞及Foxp3基因在肺癌发生、发展中的作用及机制。方法流式细胞仪检测32例肺癌合并胸腔积液患者外周血、胸腔积液及30例无胸腔积液肺癌患者外周血、胸腔冲洗液中CD4+CD2+5T细胞水平,RT-PCR法检测特异性转录因子Foxp3基因在胸腔积液及外周血中的表达。结果肺癌合并胸腔积液患者胸腔积液中CD4+CD25+T细胞水平显著高于无胸腔积液患者胸腔冲洗液及外周血;Foxp3基因在肺癌患者外周血和胸腔积液中呈高表达。结论肺癌患者外周血和胸腔积液中增高的CD4+CD2+5T细胞主要是CD4+CD2+5调节性T细胞。CD4+CD25+调节性T细胞可促进肺癌的进一步恶化,其机制可能是抑制肿瘤免疫。

CD4^+T淋巴细胞三磷酸腺苷检测在预测肝移植术后感染中的作用

目的探讨外周血CD4+T淋巴细胞内三磷酸腺苷(ATP)水平与肝移植术后感染之间的关系。方法采集肝移植术后患者外周血样本142例次,应用ImmuKnow免疫细胞功能检测试剂盒检测ATP。根据患者肝移植术后是否发生感染及不同的免疫应答状态分组,分析CD4+T淋巴细胞ATP水平与肝移植术后感染的关系。结果根据患者临床状态将患者分为感染组和非感染组,其ATP值分别为236.0(41.0~512.0)μg/L和371.5(9.0~1000.0)μg/L,两组比较差异有统计学意义(P=0.001)。根据患者外周血CD4+T淋巴细胞ATP水平将患者分为低免疫应答组、正常免疫应答组和高免疫应答组,其肝移植术后感染的发生率分别为25.0%、13.6%和0,各组间移植术后感染的发生率比较差异有统计学意义(P=0.003)。结论外周血CD4+T淋巴细胞ATP值与肝移植术后感染间具有良好的相关性,有利于指导临床治疗。

HIV感染者早期抗病毒治疗CD_4^+T淋巴细胞水平变化研究

目的了解新疆维吾尔自治区伊犁州HIV感染者早期高效抗反转录病毒治疗后CD_4^+T淋巴细胞水平的变化情况及相关影响因素。方法选取伊犁州2008年1月-2012年12月首次参加抗病毒治疗的HIV感染者(基线CD_4^+T淋巴细胞计数>350个/μl)为研究对象,收集其基线情况及治疗后各随访时点(6个月、12个月、18个月、24个月)的相关资料并进行统计分析。结果共收集311例HIV感染者信息,基线CD_4^+T淋巴细胞计数的M(P_(25),P_(75))为440(391,525)个/μl;治疗6个月与基线、12个月与6个月、18个月与12个月的CD_4^+T淋巴细胞计数比较,差异均有统计学意义(Z=-6.6,P<0.01;Z=-3.6,P<0.01;Z=-2.5,P=0.01),6、8、12、24个月时的CD_4^+T淋巴细胞计数与基线相比分别上升了84、123、143、140个/μl;CD_4^+T淋巴细胞计数有随时间变化的趋势(F=31.56,P<0.01),不同基线CD_4^+T淋巴细胞分组治疗后CD_4^+T淋巴细胞计数差异有统计学意义(F=20.54,P<0.01),>500个/μl组治疗后CD_4^+T淋巴细胞计数增长量低于351~500个/μl组。结论早期抗病毒治疗后CD_4^+T淋巴细胞计数在前6个月升高幅度较大,随后升高的幅度逐渐缓慢趋于稳定;基线CD_4^+T淋巴细胞计数越高,免疫功能恢复越好。

Changes of CD4^+CD25^+ Regulatory T Cells in Patients with Acute Coronary Syndrome and the Effects of Atorvastatin

The function of CD4＋CD25＋ regulatory T lymphocytes （Treg） in patients with acute coronary syndrome （ACS） and the effects of atorvastatin were investigated. Forty-eight patients with ACS were randomly divided into two groups： group C receiving conventional therapy （n=24）, and group C＋A receiving conventional therapy＋atorvastatin （10 mg/day, n=24）. T lymphocytes from ACS patients （before and 2 weeks after the treatment） or 18 healthy subjects were separated and the flow cytometry was used to measure the percentage of Treg. The inhibitory ability of Treg on effector T cells was determined by mixed lymphocyte reaction （MLR）. ELISA was used to measure the serum levels of cytokines （IL-10, TGF-β1 and IFN-γ） before and after treatment. The results showed that as compared with normal control group, Treg percentage was decreased significantly （P〈0.01）, the inhibitory ability of Treg on the T lymphocytes proliferation was reduced （P〈0.01）, IFN-γ levels were increased and IL-10 and TGF-β1 levels were lowered in ACS patients. After treatment with atorvastatin, Treg percentage and the inhibitory ability of Treg on T lymphocytes proliferation were significantly increased in ACS patients. Serum IFN-γ was decreased significantly, while IL-10 and TGF-β1 were elevated significantly as compared with the non-atorvastatin group. The number of Treg was positively correlated with serum TGF-β1, but negatively with serum IFN-γ and CRP. It was concluded that ACS was associated with decreased number and defected function of Treg, which may play an important role in initiating immune-inflammatory response in ACS. The inhibitory effects of atorvastatin on inflammation in ACS may be due to its beneficial effects on Treg and restoration of immune homeostasis.

女性更年期艾滋病合并肺结核患者低剂量螺旋CT动态扫描与CD_4^+T淋巴细胞相关性分析

目的探讨女性更年期艾滋病患者合并肺结核的低剂量螺旋CT表现特征及与CD_4^+T淋巴细胞计数的相关性。方法收集经临床确诊、符合女性更年期综合征的艾滋病合并肺结核病例55例为研究组,同时选择同期符合女性更年期综合征的单纯性肺结核患者42例作为对照组,对两组实施低剂量螺旋CT扫描,分析CT表现,并结合临床资料与CD_4^+T淋巴细胞水平进行统计学检验。结果 (1)CT结果显示:研究组较对照组出现较多斑片实变(76.8%vs 52.3%,P<0.05);对照组较研究组出现较多钙化(51.7%vs 0,P<0.05);两组在斑片实变、多发空洞、单发空洞、多发结节、胸腔积液、淋巴结肿大(纵隔、腋下)等方面的发病率比较差异有统计学意义(P<0.05)。(2)CD_4^+T淋巴细胞检测结果显示:研究组CD_4^+T淋巴细胞计数低于对照组(P<0.05)。在研究组中,Ⅰ型肺结核和淋巴细胞计数间呈正相关(P<0.05),Ⅲ型肺结核和淋巴细胞计数间为负相关(P<0.05),而Ⅱ型、Ⅳ型均与淋巴细胞计数无相关(P>0.05);双肺上叶病变部位和淋巴细胞计数之间无相关(P>0.05),右肺中叶、双肺下叶病变部位和淋巴细胞计数间为负相关(P<0.05);斑片实变、多发空洞、多发结节、淋巴结肿大的病例和淋巴细胞计数间呈负相关(P<0.05),单发空洞病例和淋巴细胞计数间呈正相关(P<0.05),胸腔积液病例与淋巴细胞计数间无相关(P>0.05)。结论女性更年期艾滋病患者合并肺结核的低剂量螺旋CT表现多不典型,这与CD_4^+T淋巴细胞计数减少有较大关联。了解此类患者的CT特征和CD_4^+T淋巴细胞的相关性,有益于早诊断及早治疗。