Giorgi J V, Hultin L E, McKeating J A, Johnson T D, Owens B, Jacobson L P, Shih R, Lewis J, Wiley D J, Phair J P, Wolinsky S M, Detels R
The Multicenter AIDS Cohort Study: Department of Medicine, University of California, Los Angeles, CA, 90095-1745, USA.
J Infect Dis. 1999 Apr;179(4):859-70. doi: 10.1086/314660.
To define predictors of survival time in late human immunodeficiency virus type 1 (HIV-1) disease, long- and short-duration survivors were studied after their CD4+ T cells fell to </=50/mm3. Immune activation of CD4+ and CD8+ T cells, as measured by elevated cell surface expression of CD38 antigen, was strongly associated with shorter subsequent survival (P</=.002). The naive CD45RA+CD62L+ T cell reserve was low in all subjects and did not predict survival (P=.34 for CD4+ and.08 for CD8+ cells). Higher virus burden correlated with CD8+ but not CD4+ cell activation and, after correcting for multiple comparisons, was not associated with shorter survival (P=.02). All of the patients' viruses used CCR5, CXCR4, or both, and coreceptor usage did not predict survival (P=. 27). Through mechanisms apparently unrelated to higher virus burden, immune activation is a major determinant of survival in advanced HIV-1 disease.
为了确定晚期人类免疫缺陷病毒1型（HIV-1）疾病生存时间的预测因素，在CD4+T细胞降至≤50/mm3后，对长期和短期存活者进行了研究。通过CD38抗原细胞表面表达升高来衡量的CD4+和CD8+T细胞免疫激活与随后较短的生存期密切相关（P≤0.002）。所有受试者的初始CD45RA+CD62L+T细胞储备均较低，且不能预测生存期（CD4+细胞P = 0.34，CD8+细胞P = 0.08）。较高的病毒载量与CD8+细胞激活相关，但与CD4+细胞激活无关，在进行多重比较校正后，与较短生存期无关（P = 0.02）。所有患者的病毒均使用CCR5、CXCR4或两者，共受体使用情况不能预测生存期（P = 0.27）。通过明显与较高病毒载量无关的机制，免疫激活是晚期HIV-1疾病生存的主要决定因素。
