Constans J, Ladner J, Dabis F, Brossard G, Commenges D, Leng B, Conri C
Service de Médecine interne, Hôpital Saint-André, CHRU de Bordeaux.
Presse Med. 1992;21(1):27-30.
A group of 63 patients infected by HIV and presenting with CD8 hyperlymphocytosis (CD8+) has been studied. CD8 hyperlymphocytosis was defined by the presence, during at least three months, of at least 1,500 CD8 circulating lymphocytes. The CD8+ patients (n = 63) were identified and followed within the cohort (1,444 patients) of the "Groupe d'Epidémiologie Clinique du SIDA en Aquitaine " (GECSA). CD8+ patients were compared with a control group of 126 HIV infected patients without CD8 hyperlymphocytosis recruited within the GECSA cohort and followed in the same manner during two years. The occurrence of opportunistic infections was less frequent in CD8+ patients. The proportion of patients with a CD4 lymphocyte count below 200/mm3 was lower in the CD8+ group than in the CD8- group at inclusion and at the last check-up (P less than 0.01). A tendency for longer survival and delayed onset of AIDS was noted in CD8+ patients. Such a difference in prognosis might be due to a peculiar cytotoxic response against HIV among CD8+ patients. Further follow-up of a larger group of patients is needed to confirm this hypothesis.
对一组63例感染HIV且出现CD8淋巴细胞增多（CD8+）的患者进行了研究。CD8淋巴细胞增多的定义为，至少在三个月内，循环CD8淋巴细胞至少有1500个。在“阿基坦地区艾滋病临床流行病学研究组”（GECSA）的队列（1444例患者）中识别并随访了CD8+患者（n = 63）。将CD8+患者与GECSA队列中招募的126例未出现CD8淋巴细胞增多的HIV感染患者组成的对照组进行比较，并在两年内以相同方式进行随访。CD8+患者机会性感染的发生率较低。在纳入时和最后一次检查时，CD8+组CD4淋巴细胞计数低于200/mm3的患者比例低于CD8-组（P<0.01）。注意到CD8+患者有生存时间更长和艾滋病发病延迟的趋势。这种预后差异可能是由于CD8+患者对HIV有一种特殊的细胞毒性反应。需要对更多患者进行进一步随访以证实这一假设。
