Park L P, Margolick J B, Giorgi J V, Ferbas J, Bauer K, Kaslow R, Muñoz A
Johns Hopkins School of Public Health, Baltimore, MD 21205.
J Acquir Immune Defic Syndr (1988). 1992;5(11):1124-30.
The interaction between the effects of HIV-1 infection and cigarette smoking on leukocyte profiles was studied in 307 HIV-1 seroconverters in the Multicenter AIDS Cohort Study (MACS). Longitudinal data for white blood cell (WBC) counts, WBC differentials, T cell subsets, and smoking behavior were collected semiannually for up to 7 years. Prior to seroconversion, total WBC count increased in direct proportion to daily cigarette consumption, but this effect disappeared within 3 years of seroconversion. Analyses of WBC subsets (lymphocytes, monocytes, and granulocytes) and lymphocyte subsets (CD4+, CD8+ and non-T[CD3-]) showed that smoking had only minor effects on the proportions of these cells. In contrast, HIV-1 seroconversion was associated with a dramatic decrease in CD4+ lymphocyte percentage, a large increase in CD8+ lymphocyte percentage, a small increase in total lymphocyte percentage, and small decreases in the non-T lymphocyte and granulocyte percentages. These findings indicate that the effect of smoking on CD4 cell counts is (a) nonspecific, (b) maximal in seronegative individuals; and (c) lost by 3 years after seroconversion. Although the mechanism of the loss of smoking-induced leukocytosis after seroconversion remains to be determined, our results suggest that the effects of smoking are not likely to be important in the clinical use of leukocyte measurements, including measurements of CD4 lymphocytes, in individuals who have been HIV-1 seropositive for more than 3 years.
在多中心艾滋病队列研究（MACS）中，对307名HIV-1血清转化者进行了HIV-1感染效应与吸烟对白细胞谱影响之间相互作用的研究。每半年收集一次白细胞（WBC）计数、WBC分类、T细胞亚群和吸烟行为的纵向数据，为期长达7年。在血清转化前，总WBC计数与每日吸烟量成正比增加，但这种效应在血清转化后3年内消失。对WBC亚群（淋巴细胞、单核细胞和粒细胞）和淋巴细胞亚群（CD4 +、CD8 +和非T[CD3 -]）的分析表明，吸烟对这些细胞比例的影响较小。相比之下，HIV-1血清转化与CD4 +淋巴细胞百分比的显著下降、CD8 +淋巴细胞百分比的大幅增加、总淋巴细胞百分比的小幅增加以及非T淋巴细胞和粒细胞百分比的小幅下降有关。这些发现表明，吸烟对CD4细胞计数的影响是：（a）非特异性的；（b）在血清阴性个体中最大；（c）在血清转化后3年消失。虽然血清转化后吸烟诱导的白细胞增多症消失的机制仍有待确定，但我们的结果表明，对于HIV-1血清阳性超过3年的个体，吸烟的影响在白细胞测量（包括CD4淋巴细胞测量）的临床应用中可能并不重要。
