接受干扰素-α-2a和利巴韦林治疗的丙型肝炎合并HIV感染患者的T淋巴细胞亚群

T-lymphocyte populations in hepatitis C and HIV co-infected patients treated with interferon-alfa-2a and ribavirin.

作者信息

Neau D, Galpérine T, Legrand E, Pitard V, Neau-Cransac M, Moreau J F, Ragnaud J M, Dupon M, Fleury H, Lafon M E

机构信息

Federation of Infectious Diseases, Pellegrin University Hospital, Bordeaux, France.

出版信息

HIV Med. 2003 Apr;4(2):120-6. doi: 10.1046/j.1468-1293.2003.00140.x.

DOI:10.1046/j.1468-1293.2003.00140.x

PMID:12702132

Abstract

OBJECTIVE

The effects on T-lymphocyte populations of two interferon-alfa-2a (IFN) regimens associated with ribavirin were evaluated in 36 HCV-HIV co-infected patients with chronic hepatitis C, T-CD4 cell count > 250 cells/ micro L and a plasma viral load of < 10 000 HIV RNA copies/mL.

METHODS

Patients were given IFN for 48 weeks. Group A (18 patients) received 6 mega units (MU) subcutaneously three times a week for 24 weeks, then 3 MU three times a week for the last 24 weeks. Group B (18 patients) received 9 MU daily for 2 weeks, 3 MU daily for 22 weeks, then 3 MU three times a week for the last 24 weeks. Serum HCV RNA was evaluated at weeks 12 and 72. Ribavirin was added at week 16 for virologic nonresponders at week 12. CD3, CD3 CD4, CD3 CD8, CD3 CD4 human leucocyte antigen (HLA)-DR and CD3 CD8 HLA-DR lymphocyte subsets were evaluated before, during and after treatment by cytofluorometry. Controls were healthy and HCV mono-infected patients.

RESULTS

CD3 CD4 and CD3 CD8 T-cells counts were both impaired during anti-HCV therapy, but returned to baseline value after treatment completion. Lymphopenia concerned mainly CD8 T-cells, the percentage of which decreased, whereas that of CD4 increased. Three patients displayed reversible CD4 lymphopenia < 200 cells/ micro L. HIV infection at inclusion was responsible for higher CD3 CD8 HLA-DR T-cell percentages in co-infected patients than in healthy and HCV mono-infected subjects. T-cell sequestration in lymphoid tissues and enhanced apoptosis may account for lymphopenia.

CONCLUSION

High-dosed IFN anti-HCV therapy induced only moderate and transient CD4 lymphopenia in HIV co-infected patients.

摘要

目的

在36例慢性丙型肝炎合并HIV感染患者中评估两种与利巴韦林联用的干扰素-α2a（IFN）方案对T淋巴细胞亚群的影响，这些患者的T-CD4细胞计数>250个/微升，血浆病毒载量<10000 HIV RNA拷贝/毫升。

方法

患者接受IFN治疗48周。A组（18例患者）皮下注射6百万单位（MU），每周3次，共24周，然后在最后24周每周3次，每次3 MU。B组（18例患者）每天接受9 MU，共2周，每天3 MU，共22周，然后在最后24周每周3次，每次3 MU。在第12周和第72周评估血清HCV RNA。对于第12周病毒学无应答者，在第16周添加利巴韦林。通过细胞荧光测定法在治疗前、治疗期间和治疗后评估CD3、CD3 CD4、CD3 CD8、CD3 CD4人类白细胞抗原（HLA）-DR和CD3 CD8 HLA-DR淋巴细胞亚群。对照组为健康和单纯HCV感染患者。

结果

抗HCV治疗期间CD3 CD4和CD3 CD8 T细胞计数均受损，但治疗结束后恢复至基线值。淋巴细胞减少主要涉及CD8 T细胞，其百分比下降，而CD4百分比增加。3例患者出现可逆性CD4淋巴细胞减少<200个/微升。纳入时的HIV感染导致合并感染患者的CD3 CD8 HLA-DR T细胞百分比高于健康和单纯HCV感染受试者。淋巴细胞在淋巴组织中的隔离和凋亡增加可能是淋巴细胞减少的原因。