Leng Q, Borkow G, Weisman Z, Stein M, Kalinkovich A, Bentwich Z
R. Ben-Ari Institute of Clinical Immunology and AIDS Center, Kaplan Medical Center, Hebrew University Hadassah Medical School, Rehovot, Israel.
J Acquir Immune Defic Syndr. 2001 Aug 1;27(4):389-97. doi: 10.1097/00126334-200108010-00010.
This study addressed the role of T-cell immune activation in determining HIV-1 plasma viral load and CD4+ T-cell blood levels during HIV-1 infection. A decrease of blood CD4 levels and CD4/CD8 ratios and an increase of CD8 levels in both treated (n = 35) and untreated (n = 19) HIV-positive individuals were more strongly correlated to immune activation (log percentage of HLA-DR+CD3+ cells; R = -0.78, R = -0.77, and R = 0.58, respectively; p <.0001) than to CD4 T-cell proliferation (log percentage of Ki-67+CD4+ cells; R = -0.57 [p <.0001], R = -0.48 [p <.001], and R = 0.37 [p <.01], respectively) or to viral load (R = -0.36 [p <.01], R = -0.23 [p =.09], R = 0.13 [p =.35], respectively). Because almost half of the Ki-67+CD4+ cells were also positive for CTLA-4 (a marker for activated nonproliferating cells), the correlation of CD4 levels to Ki-67 expression is only partially related to cell proliferation and more likely represents mainly immune activation of the cells without proliferation. Taken together, these results suggest that immune activation is the major determinant of CD4 decline and should therefore be considered central for the monitoring of HIV infection and its outcome after antiviral treatment.
本研究探讨了T细胞免疫激活在确定HIV-1感染期间HIV-1血浆病毒载量和CD4+ T细胞血液水平方面的作用。在接受治疗的（n = 35）和未接受治疗的（n = 19）HIV阳性个体中，血液CD4水平和CD4/CD8比值的降低以及CD8水平的升高与免疫激活（HLA-DR+CD3+细胞的对数百分比；R分别为-0.78、-0.77和0.58；p <.0001）的相关性，比与CD4 T细胞增殖（Ki-67+CD4+细胞的对数百分比；R分别为-0.57 [p <.0001]、-0.48 [p <.001]和0.37 [p <.01]）或病毒载量（R分别为-0.36 [p <.01]、-0.23 [p =.09]、0.13 [p =.35]）的相关性更强。由于几乎一半的Ki-67+CD4+细胞也为CTLA-4阳性（活化的非增殖细胞的标志物），CD4水平与Ki-67表达的相关性仅部分与细胞增殖有关，更可能主要代表未增殖细胞的免疫激活。综上所述，这些结果表明免疫激活是CD4下降的主要决定因素，因此应被视为监测HIV感染及其抗病毒治疗后结果的核心因素。
