Anti-hepatitis C virus therapy in chronic kidney disease patients improves long-term renal and patient survivals

BACKGROUND Hepatitis C virus (HCV) infection is a documented risk factor for chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD). However, to date there are no reports on the long-term hard endpoints (ESRD and death) of anti-HCV therapy [interferon-based therapy (IBT) or new direct-acting antivirals] in CKD patients. Direct-acting antivirals are not available in Taiwan’s singlepayer national health insurance database currently released for research. Therefore, we hypothesized that a retrospective analysis of the long-term outcomes of IBT in CKD patients will serve as a proxy for direct-acting antivirals to increase our understanding of progression to ESRD following HCV infection. AIM To evaluate the long-term outcomes (ESRD and death) of anti-HCV therapy, especially IBT, in HCV-infected patients with stage 1-5 CKD. METHODS We analyzed 93894 Taiwan Residents adults diagnosed with CKD and without HBV infection. Of these, 4.9% were infected with HCV. Of the 4582 HCV-infected CKD patients, 482 (10.5%) received IBT (treated cohort). They were matched 1:4 with 1928 untreated HCV-infected CKD patients (untreated cohort) by propensity scores and year, which further matched 1:2 by propensity scores with 3856 CKD patients without HCV infection (uninfected cohort). All participants were followed until the occurrence of ESRD, death, or the end of 2012. The association between HCV infection, IBT use, and risks of ESRD and death was analyzed using competing risk analysis. RESULTS Taking the uninfected cohort as a reference, the adjusted hazard ratios for ESRD, after adjusting for competing mortality, were 0.34 (0.14-0.84, P = 0.019) and 1.28 (1.03-1.60, P = 0.029) in the treated and untreated cohorts, respectively. The treated cohort had a 29%(0.54-0.92, P = 0.011) decrease in mortality compared to the untreated cohort, in which the mortality was 31%(1.18-1.45, P < 0.001) higher than in the uninfected cohort. The reduced risks of ESRD (0.14, 0.03–0.58, P = 0.007) and death (0.57, 0.41-0.79, P = 0.001) were greatest in HCV-infected CKD patients who received at least 4 mo of IBT, which accounted for 74% of the treated cohort.CONCLUSION Adequate anti-HCV therapy in CKD patients improves long-term renal and patient survival.

Antiviral effects of hepatitis B virus S gene-specific anti-gene locked nucleic acid in transgenic mice

AIM To assess the antiviral effects of hepatitis B virus(HBV) S gene-specific anti-gene locked nucleic acid(LNA) in transgenic mice.METHODS Thirty HBV transgenic mice were acclimatized to laboratory conditions and positive for serum HBV surface antigen(HBs Ag) and HBV DNA, were randomly divided into 5 groups(n = 7), including negative control(blank control, unrelated sequence control), positive control(lamivudine, anti-sense-LNA), and anti-gene-LNA experimental group. LNA was injected into transgenic mice by tail vein while lamivudine was administeredby gavage. Serum HBV DNA and HBs Ag levels were determined by fluorescence-based PCR and enzymelinked immune sorbent assay, respectively. HBV S gene expression amounts were assessed by reverse transcription polymerase chain reaction. Positive rates of HBsA g in liver cells were evaluated immunohistochemistry.RESULTS Average rate reductions of HBs Ag after treatment on the 3 rd, 5 th, and 7 th days were 32.34%, 45.96%, and 59.15%, respectively. The inhibitory effect of antigene-LNA on serum HBs Ag peaked on day 7, with statistically significant differences compared with pretreatment(0.96 ± 0.18 vs 2.35 ± 0.33, P < 0.05) and control values(P < 0.05 for all). Average reduction rates of HBV DNA on the 3 rd, 5 th, and 7 th days were 38.55%, 50.95%, and 62.26%, respectively. This inhibitory effect peaked on the 7 th day after treatment with anti-gene-LNA, with statistically significant differences compared with pre-treatment(4.17 ± 1.29 vs 11.05 ± 1.25, P < 0.05) and control values(P < 0.05 for all). The mR NA levels of the HBV S gene(P < 0.05 for all) and rates of HBsA g positive liver cells(P < 0.05 for all) were significantly reduced compared with the control groups. Liver and kidney function, and histology showed no abnormalities. CONCLUSION Anti-gene-LNA targeting the S gene of HBV displays strong inhibitory effects on HBV in transgenic mice, providing theoretical and experimental bases for gene therapy in HBV.

Specific activation of 2'-5'oligoadenylate synthetase gene promoter by hepatitis C virus-core protein:A potential for developing hepatitis C virus targeting gene therapy

AIM： TO examine whether 2＇-5＇oligoadenylate synthetase （OAS） gene promoter can be specifically activated by hepatitis C virus （HCV）-core protein. METHODS： Human embryo hepatic cell line L02 was transfected with pcDNA3.1-core plasmid and selected by G418. Expression of HCV-core was detected by reverse transcription polymerase chain reaction and Western blotting. The OAS promoter sequence was amplified from the genomic DNA and inserted into pGL3-basic vector. The resultant pGL3-OAS-Luci plasmid was transiently transfected into L02/core cells and luciferase activity was assayed. I^ESULTS： L02/core cell line stably expressing HCV- core protein was established. The pGL3-OAS-Luci construct exhibited significant transcriptional activity in the L02/core cells but not in the L02 cells. CONCLUSION： HCV-core protein activates the OAS gene promoter specifically and effectively. Utilization of OAS gene promoter would be an ideal strategy for developing HCV-specific gene therapy.

Hepatitis C in human immunodeficiency virus co-infected individuals: Is this still a “special population”?

A substantial proportion of individuals with chronic hepatitis C virus(HCV) are co-infected with human immunodeficiency virus(HIV). Co-infected individuals are traditionally considered as one of the "special populations" amongst those with chronic HCV, mainly because of faster progression to end-stage liver disease and suboptimal responses to treatment with pegylated interferon alpha and ribavirin, the benefits of which are often outweighed by toxicity. The advent of the newer direct acting antivirals(DAAs) has given hope that the majority of co-infected individuals can clear HCV. However the "special population" designation may prove an obstacle for those with co-infection to gain access to the new agents, in terms of requirement for separate pre-licensing clinical trials and extensive drug-drug interaction studies. We review the global epidemiology, natural history and pathogenesis of chronic hepatitis C in HIV co-infection. The accelerated course of chronic hepatitis C in HIV co-infection is not adequately offset by successful combination antiretroviral therapy. We also review the treatment trials of chronic hepatitis C in HIV co-infected individuals with DAAs and compare them to trials in the HCV mono-infected. There is convincing evidence that HIV co-infection no longer diminishes the response to treatment against HCV in the new era of DAA-based therapy. The management of HCV co-infection should therefore become a priority in the care of HIV infected individuals, along with public health efforts to prevent new HCV infections, focusing particularly on specific patient groups at risk, such as men who have sex with men and injecting drug users.

COVID-19 Coronavirus: Is Infection along with <i>Mycoplasma</i>or Other Bacteria Linked to Progression to a Lethal Outcome?

Most patients with COVID-19 disease caused by the SARS-CoV-2 virus recover from this infection, but a significant fraction progress to a fatal outcome. As with some other RNA viruses, co-infection or activation of latent bacterial infections along with pre-existing health conditions in COVID-19 disease may be important in determining a fatal disease course. Mycoplasma spp. (M. pneumonaie, M. fermentans, etc.) have been routinely found as co-infections in a wide number of clinical conditions, and in some cases this has progressed to a fatal disease. Although preliminary, Mycoplasma pneumoniae has been identified in COVID-19 disease, and the severity of some signs and symptoms in progressive COVID-19 patients could be due, in part, to Mycoplasma or other bacterial infections. Moreover, the presence of pathogenic Mycoplasma species or other pathogenic bacteria in COVID-19 disease may confer a perfect storm of cytokine and hemodynamic dysfunction, autoimmune activation, mitochondrial dysfunction and other complications that together cannot be easily corrected in patients with pre-existing health conditions. The positive responses of only some COVID-19 patients to antibiotic and anti-malaria therapy could have been the result of suppression of Mycoplasma species and other bacterial co-infections in subsets of patients. Thus it may be useful to use molecular tests to determine the presence of pathogenic Mycoplasma species and other pathogenic bacteria that are commonly found in atypical pneumonia in all hospitalized COVID-19 patients, and when positive results are obtained, these patients should treated accordingly in order to improve clinical responses and patient outcomes.

Relationship between HBV genotypes and anti-viral therapeutic efficacy of interferon-alpha

BACKGROUND: Much evidence demonstrates that the genotypes of hepatitis B virus (HBV) present differences in pathogenicity and outcomes owing to differences in genetic structure. This study aimed to investigate the influences of HBV genotypes on the anti-viral therapeutic efficacy of interferon-alpha (IFN-alpha) in chronic hepatitis B patients, and to determine the relationship between HBV genotypes and levels of viral replication or gene variations. METHODS: The chronic hepatitis B patients who were treated with IFN-alpha were selected randomly. Anti-viral therapeutic efficacy was monitored in these patients. The HBV genotypes were detected by PCR microplate hybridization ELISA. The levels of serum HBV-DNA were determined by fluorescence quantitative PCR. HBV gene variation at pre-C and basic core promoter (BCP) regions were assayed by gene chip technology. RESULTS: Genotypes B and C were predominant in 94 chronic hepatitis B patients. A, E and F genotypes were not found in these patients. The HBV-DNA levels of genotype C and mixed genotypes were significantly higher than those of genotype B. The response to IFN-alpha in patients with genotype B was markedly better than in those with genotypes C and D, and the complete response to IFN-alpha was only observed in genotype B. The response to IFN-alpha in patients with mixed genotypes was the least sensitive. The negative transition of HBeAg was correlated with variations in the HBV pre-C and BCP regions in patients with partial or no response to IFN-alpha. The variation rates of HBV pre-C and BCP regions were clearly higher in genotype C than in genotype B. CONCLUSIONS: The results suggest that HBV genotype is correlated with the serum levels of HBV-DNA, HBV gene variations and therapeutic efficacy of IFN-alpha. The regular detection of HBV genotypes in the clinic will be of benefit for disease prognosis and planning of anti-viral therapeutic strategies.

Hepatitis C: From inflammatory pathogenesis to antiinflammatory/hepatoprotective therapy

Hepatitis C virus(HCV) infection commonly causes progressive liver diseases that deteriorate from chronic inflammation to fibrosis, cirrhosis and even to hepatocellular carcinoma. A long-term, persistent and uncontrolled inflammatory response is a hallmark of these diseases and further leads to hepatic injury and more severe disease progression. The levels of inflammatory cytokines and chemokines change with the states of infection and treatment, and therefore, they may serve as candidate biomarkers for disease progression and therapeutic effects. The mechanisms of HCV-induced inflammation involve classic pathogen pattern recognition, inflammasome activation, intrahepatic inflammatory cascade response, and oxidative and endoplasmic reticulum stress. Direct-acting antivirals(DAAs) are the first-choice therapy for effectively eliminating HCV, but DAAs alone are not sufficient to block the uncontrolled inflammation and severe liver injury in HCV-infected individuals. Some patients who achieve a sustained virologic response after DAA therapy are still at a long-term risk for progression to liver cirrhosis and hepatocellular carcinoma. Therefore, coupling with antiinflammatory/hepatoprotective agents with anti-HCV effects is a promising therapeutic regimen for these patients during or after treatment with DAAs. In this review, we discuss the relationship between inflammatory mediators and HCV infection, summarize the mechanismsof HCV-induced inflammation, and describe the potential roles of anti-inflammatory/hepatoprotective drugs with anti-HCV activity in the treatment of advanced HCV infection.

Exploitation of host clock gene machinery by hepatitis viruses B and C

Many aspects of cellular physiology display circadian(approximately 24-h)rhythms.Dysfunction of the circadian clock molecular circuitry is associated with human health derangements,including neurodegeneration,increased risk of cancer,cardiovascular diseases and the metabolic syndrome.Viruses triggering hepatitis depend tightly on the host cell synthesis machinery for their own replication,survival and spreading.Recent evidences support a link between the circadian clock circuitry and viruses’biological cycle within host cells.Currently,in vitro models for chronobiological studies of cells infected with viruses need to be implemented.The establishment of such in vitro models would be helpful to better understand the link between the clock gene machinery and viral replication/viral persistence in order to develop specifically targeted therapeutic regimens.Here we review the recent literature dealing with the interplay between hepatitis B and C viruses and clock genes.

Hepatitis C virus infection and insulin resistance

Approximately 170 million people worldwide are chronically infected with hepatitis C virus(HCV).Chronic HCV infection is the leading cause for the development of liver fibrosis,cirrhosis,hepatocellular carcinoma(HCC)and is the primary cause for liver transplantation in the western world.Insulin resistance is one of the pathological features in patients with HCV infection and often leads to development of typeⅡdiabetes.Insulin resistance plays an important role in the development of various complications associated with HCV infection.Recent evidence indicates that HCV associated insulin resistance may result in hepatic fibrosis,steatosis,HCC and resistance to anti-viral treatment.Thus,HCV associated insulin resistance is a therapeutic target at any stage of HCV infection.HCV modulates normal cellular gene expression and interferes with the insulin signaling pathway.Various mechanisms have been proposed in regard to HCV mediated insulin resistance,involving up regulation of inflammatory cytokines,like tumor necrosis factor-α,phosphorylation of insulin-receptor substrate-1,Akt,up-regulation of gluconeogenic genes like glucose 6 phosphatase,phosphoenolpyruvate carboxykinase 2,and accumulation of lipid droplets.In this review,we summarize the available information on how HCV infection interferes with insulin signaling pathways resulting in insulin resistance.

青年男性-人类免疫缺陷病毒感染-低骨量

骨骼疾病是人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者常见并发症之一,HIV感染及抗反转录病毒治疗(anti-retroviral therapy, ART)药物均可影响骨代谢,但因起病隐匿,容易被患者及临床医生忽略。本文报告1例青年男性在HIV感染后出现骨量减低,在ART的同时给予钙剂、维生素D及活性维生素D治疗,但ART治疗前2年,骨量进一步下降,经双膦酸盐治疗后,患者破骨细胞活性明显降低,骨量稳定。

逆转“白肺”——重症COVID-19的治疗及思考

新型冠状病毒感染(COVID-19)近期在我国全国范围大流行。本文报道了1例重症COVID-19感染患者的救治过程,以期为临床治疗重症COVID-19患者提供相关诊疗思路。本文对治疗过程中遇到的问题进行了总结与探讨:针对抗炎药物的选择及应用,介绍了糖皮质激素甲泼尼龙、托珠单抗、巴瑞替尼的应用;针对抗炎和抗感染治疗过程中的注意事项,介绍了COVID-19患者的自然病程可以分为3个阶段,不同时间段进行抗炎和抗感染治疗应有不同的侧重;针对患者D-二聚体迅速升高,分析了重症COVID-19患者凝血异常的原因,并探讨了抗凝治疗方案。COVID-19可通过炎症风暴累及全身多个系统/器官,临床医师应广泛借鉴国内外治疗经验,及时采取适当措施予以施治,以提高救治成功率。

南通市HIV合并HBV感染者抗逆转录病毒疗效及影响因素分析

目的:了解人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者合并乙型肝炎病毒(hepatitis B virus,HBV)的感染现况和特征,分析HIV/HBV合并感染者抗逆转录病毒治疗(anti-retroviral therapy,ART)效果及影响因素。方法:选取南通市2016年1月—2021年12月新确诊的HIV感染者为调查对象,根据乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)检测结果分为HIV单独感染组1 830例和HIV/HBV合并感染组135例,比较两组患者ART前HIV感染特征,分析ART后HIV病毒学抑制和CD4+T淋巴细胞变化情况,以评估免疫功能改善情况及影响因素。结果:HIV/HBV合并感染者ART前免疫受损重于HIV单独感染者。接受ART后,HIV单独感染组和HIV/HBV合并感染组的CD4+T计数总体上均随治疗时间延长呈上升趋势,ART 2年后,两组患者的HIV病毒学抑制率均为90%以上。单因素和多因素Logistic回归分析均显示开始ART的年龄增加、初始CD4+T <200个/μL、初始HIV RNA≥4.5[lg(copies/mL)]是影响免疫重建的危险因素。随治疗时间的延长,免疫重建良好率有增加趋势。在ART前合并HBV感染加重HIV感染者的免疫损伤,因而可能影响免疫重建。结论:HBV感染可加重HIV感染者的免疫损伤,现行HIV/HBV合并感染的ART策略可有效抑制双重感染,有利于HIV/HBV合并感染者的免疫重建。在感染者的干预管理中,ART及疗效监测均存在不足,临床诊疗活动需进一步规范。

2015年乐山市HIV-1抗体阳性病例抗病毒治疗效果及耐药分析

目的分析乐山市接受抗病毒治疗的HIV-1抗体阳性病例治疗效果及毒株耐药、突变情况。方法选取乐山市2015年接受抗病毒治疗时间>6个月的HIV-1抗体阳性病例共计620例,采集其抗凝全血进行病毒载量检测,对病毒载量>1 000copy/mL的样本采用自建基因型耐药检测进行耐药检测及分析。结果 620例患者中,419例病毒载量<200copy/mL,抗病毒治疗有效率为67.58%;175例病毒载量>1 000copy/mL,均值1.85×105copy/mL,病毒抑制失败率28.22%;其中93例样本核酸扩增阳性,主要为CRF07-BC亚型(占68.82%)和CRF01-AE亚型(占19.35%)。总耐药率6.13%(33/538),其中对核苷类反转录酶抑制剂(NRTIs)、非核苷类反转录酶抑制剂(NNRTIs)和蛋白酶抑制剂(PIs)的耐药率分别为57.58%、84.85%和18.18%;耐药毒株对NRTI主要突变位点为M184V、K65R,对NNRTI主要突变位点为K103N、K101E、Y181C、G190A,对PI未发现主要位点突变,次要突变位点主要是Q58E、A71V。结论乐山地区部分HIV-1抗体阳性患者抗病毒治疗效果较差。与2014年相比,总耐药率及对NRTIs、NNRTIs耐药率均有所下降,但对PI耐药率上升。应加强对接受HAART的HIV-1抗体阳性病例的病毒载量及耐药检测,及时评估治疗效果及耐药情况。

感染HIV-1儿童经抗病毒治疗后乳酸浓度检测及其相关因素研究

目的研究中国感染艾滋病毒(human immunodeficiency virus type 1,HIV-1)儿童经抗病毒治疗后血浆乳酸浓度及相关影响因素。方法选择31例抗病毒治疗的感染HIV-1儿童与30例正常对照儿童,检测血浆乳酸浓度,结合儿童的基本信息、治疗方案及实验室检测结果进行综合分析。结果感染HIV-1患儿血浆乳酸浓度(2.32±0.60)mmol/L显著高于对照组儿童(1.60±0.88)mmol/L(P<0.01);d4T治疗组和AZT治疗组间血浆乳酸浓度、基线CD4+T淋巴细胞计数、基线病毒载量、性别、年龄以及HIV-1传播途径差异均无统计学意义(P>0.05)。结论外周血乳酸浓度可反映感染HIV-1儿童经抗病毒治疗后的线粒体毒性,有望成为线粒体毒性检测指标。

HIV-1耐药性相关研究进展

随着高效抗逆转录病毒治疗(highly active anti-retroviral therapy,HAART)的应用和推广,人免疫缺陷病毒(human immunodeficiency virus,HIV)耐药性的问题日益突出。目前,HIV-1型病毒(HIV-1)耐药现象普遍存在,且其耐药率处于较高水平,已成为影响艾滋病(acquired immunodeficiency syndrome,AIDS)防治工作的突出难题。鉴于HIV-1耐药问题的重要影响,现就HIV-1耐药的产生和进化、耐药现状及其耐药机制作一概述。

接受不同抗逆转录病毒治疗方案的HIV感染者血浆中可溶性炎症标志物水平差异研究

目的探究接受不同抗逆转录病毒治疗(ART)方案的人类免疫缺陷病毒(HIV)感染者血浆中可溶性炎症标志物表达水平的差异。方法选取2019年6月至2021年6月于海南省中医院就诊的初诊HIV感染者100例,随机将患者分为非核苷类逆转录酶抑制剂(NNRTI)组和整合酶链转移抑制剂(INSTI)组,各50例。所有患者基础用药为恩曲他滨替诺福韦片,NNRTI组患者联用依非韦伦片,INSTI组患者联用拉替拉韦钾片。分别于治疗前及治疗6个月后随访,比较两组患者血生化指标、T细胞计数、病毒学指标、炎性细胞因子表达。结果治疗6个月后两组患者血生化指标、T细胞计数、病毒学指标及血浆炎性细胞因子表达水平较治疗前均有显著差异(P<0.05),且INSTI组患者各项指标改变更显著(P<0.05)。结论相比NNRTI,应用INSTI更有助于降低HIV感染者全身炎症水平,且药物抑制病毒效果显著。

复方药物ZL-1在鸭乙型肝炎病毒实验感染模型中抗病毒作用的研究

目的 研究中药复方ZL 1在鸭乙型肝炎病毒 (DHBV)持续性感染模型中抗嗜肝DNA病毒的作用。方法应用中药复方ZL 1治疗实验感染鸭 ,口服给药 ,剂量 5 0 0mg·kg-1·d-1,分 2次服用 ,连续 4周。采用斑点分子杂交和Southern印迹杂交检测治疗后感染鸭血清和肝脏中病毒的动态变化。同时以拉米夫定及安慰剂作为对照组。结果 复方药物ZL 1治疗后血清中DHBVDNA均数从 3 .6× 10 10 拷贝 /ml下降至 0 .9× 10 10 拷贝 /ml(P <0 .0 1) ,抑制病毒率为 75 % ,但尚不能清除病毒血症 ,肝组织中总DHBVDNA和DHBV超螺旋型DNA量无明显减少 ,停药观察 2周 ,病毒复制反弹不明显。拉米夫定治疗后可显著降低病毒血症 (P <0 .0 1) ,抑制病毒率达 99% ,同时肝组织中总DHBVDNA和DHBV超螺旋型DNA量减少 ,但停药观察 2周 ,病毒复制反弹明显。安慰剂组 (口服生理盐水 )治疗前后病毒水平的差异无显著性 (P >0 .0 5 )。结论 复方药物ZL 1治疗4周可使感染鸭病毒血症降低 ,但不能清除病毒血症 。

miR-23a-3p､miR-155､miR-124a表达变化与艾滋病患者高效抗逆转录病毒治疗效果的相关性分析

目的探究miR-23 a-3 p､miR-155､miR-124a表达变化与艾滋病患者高效抗逆转录病毒治疗(HAART)效果的相关性。方法选取2019年1月至2020年1月武汉市金银潭医院收治的152例艾滋病患者,按照随机数字表法分为胸腺五肽组和HAART组,各76例。胸腺五肽组给予胸腺五肽治疗,HAART组给予HAART。对比两组患者治疗有效率及不良反应发生情况,分析miR-23 a-3 p､miR-155､miR-124a表达量与治疗效果的相关性。结果治疗后两组患者CD4^(+)计数､CD8^(+)计数上升,人类免疫缺陷病毒(HIV)载量下降,且与胸腺五肽组相比,HAART组CD4^(+)计数､CD8^(+)计数较高,HIV病毒载量较低,差异具有统计学意义(P<0.05);治疗后两组患者miR-23 a-3 p､miR-155､miR-124a表达下降,且与胸腺五肽组相比,HAART组患者miR-23 a-3 p､miR-155､miR-124a表达较低,差异具有统计学意义(P<0.05);CD4^(+)T淋巴细胞计数与miR-23 a-3 p､miR-155､miR-124a表达均呈负相关(r=-0.336､-0.525､-0.298,P=0.003､0.001､0.010)。结论艾滋病患者采用HAART,有较好的临床效果,且miR-23 a-3 p､miR-155､miR-124a表达会随着治疗效果的不同而发生变化。

血β_2-微球蛋白在25例获得性免疫缺陷综合征高效抗逆转录病毒治疗疗效判断中的作用

目的了解血β2-微球蛋白(β2-MG)在获得性免疫缺陷综合征(AIDS)高效抗逆转录病毒治疗(HAART)疗效判断中的作用。方法25例AIDS患者接受HAART 1年。治疗前及治疗开始后第1、3、6、9和12个月底检测CD4+细胞计数、人类免疫缺陷病毒(HIV)-RNA载量和血β2-MG。对治疗前、后的数据进行配对分析和相关性分析。结果治疗第1、3、6、9和12个月时CD4+细胞计数较治疗前显著上升(P值均< 0．01),HIV-RNA载量较治疗前显著下降(P值均<0．01)。治疗第3、9和12个月时血β2-MG较治疗前亦显著下降(P<0．05或0．01)。血β2-MG与CD4+细胞计数和HIV-RNA的Person相关系数分别为-0．203和0．224(P<0．05)。结论血β2-MG在HAART疗效判断中有一定的监测作用。

CD4+ T-Cell Count, Serum Zinc, Copper and Selenium Levels in HIV Sero-Positive Subjects on ART and ART Naïve Subjects in Port Harcourt, Nigeria

Background: HIV infection results in depletion of immunocompetent cells such as CD4+ T-cells. Trace elements such as Copper, Zinc and selenium are known to be involved in immune function. In recent times, HIV-positive patients are treated with antiretroviral therapy (ART), with significant progress. This study was aimed at evaluating CD4+ T-cells levels, serum Copper, Zinc and Selenium levels in HIV seropositive subjects on ART and ART naive subjects (HIV positive subjects that have not started ART treatment) in Rivers State, Nigeria. Methods: 150 subjects aged 20 to 79 years were recruited after informed consent. 70 subjects were HIV-positive on ART, 30 subjects were HIV-positive ART naïve subjects, while 50 subjects were apparently healthy subjects. Ten (10) milliliters of blood was collected using a standard venipuncture technique from each subject for the analysis of CD4 T-cells using BD fluorescent activated cell sorter (FACSC count), serum Copper and Zinc were analyzed colorimetrically using semi auto-analyzer WP 21E, while selenium was analyzed using atomic absorption spectrophotometer ELICO, SL173. Data generated were analyzed using Graph-Pad Prism version 8.0.2 and p Result: This study revealed a significant reduction in mean zinc, selenium and CD4+ T-cell level respectively (p = 0.0006;0.0001;0.0001) in HIV-Positive subjects on ART and ART naive. There was also a significant increase in mean serum copper level in the HIV-positive subject as compared to control subjects (p = 0.0001). ART treatment improved the CD4+ T cell count and serum levels of selenium and zinc;however, ART did not correct the imbalance. Furthermore, female subjects on ART have a significantly higher CD4+ T-cell count than the males (p Conclusion: Selenium and Zinc deficiency are associated with HIV disease despite the role of ART hence micronutrient supplementation is advised for HIV-positive subjects on ART.