Miguez Maria Jose, Rodríguez Allan, Hadrigan Sonya, Asthana Deshratn, Burbano Ximena, Fletcher Mary Ann
Department of Psychiatry, Division of Disease Prevention, University of Miami, School of Medicine, Miami, FL 33136, USA.
Platelets. 2005 Aug;16(5):281-6. doi: 10.1080/09537100400028727.
The present cross-sectional study evaluated the status and relationship of interleukin-6, a platelet growth factor, with platelet counts, viral load, CD4 counts, and antiretroviral treatment in 75 HIV-infected subjects with thrombocytopenia and 50 gender-, race-, age- and antiretroviral treatment-matched controls without thrombocytopenia. Mean IL-6 production was significantly higher in thrombocytopenic participants (13 432+/-8596) than in non-thrombocytopenic subjects (12 859+/-3538 pg/10(5) Lym). Univariate analyses indicated, however, that thrombocytopenic patients were more likely to have <3000 pg of IL-6 than non-thrombocytopenic patients (OR=7 95% CI 1.3-12; P=0.01). For additional analyses, participants were dichotomized above and below 3000 pg of IL-6. Despite similar age, gender, drug use and antiretroviral treatment, thrombocytopenic participants had lower CD4 counts (186.5+/-149 vs. 401+/-286, P=0.005) than non-thrombocytopenic subjects. Thrombocytopenic participants with elevated IL-6, with or without HAART, were more likely to have higher HIV-replication (496 273+/-210 416; 34 656+/-25 332) than thrombocytopenic individuals with low IL-6 levels (105 332+/-42 699; 19 015+/-14 296 P=0.05). Non-thrombocytopenic patients with high IL-6 levels exhibited the highest CD4s (466.7+/-333) and the lowest viral burden (63 094+/-53 300) of the groups. Two distinct categories of HIV-associated thrombocytopenia exist: one accompanied by low IL-6, and another with compensatory elevations of IL-6. In thrombocytopenic individuals, the latter was associated with the poorest immunological and virological responses.
本横断面研究评估了75例感染HIV且患有血小板减少症的受试者以及50例性别、种族、年龄和抗逆转录病毒治疗相匹配但无血小板减少症的对照者中，血小板生长因子白细胞介素-6的状态及其与血小板计数、病毒载量、CD4细胞计数和抗逆转录病毒治疗的关系。血小板减少症参与者的平均白细胞介素-6生成量（13432±8596）显著高于非血小板减少症受试者（12859±3538 pg/10⁵淋巴细胞）。然而，单因素分析表明，血小板减少症患者白细胞介素-6低于3000 pg的可能性高于非血小板减少症患者（比值比=7，95%置信区间1.3 - 12；P=0.01）。为进行进一步分析，将参与者按白细胞介素-6高于或低于3000 pg进行二分。尽管年龄、性别、药物使用情况和抗逆转录病毒治疗相似，但血小板减少症参与者的CD4细胞计数（186.5±149对401±286，P=0.005）低于非血小板减少症受试者。白细胞介素-6升高的血小板减少症参与者，无论是否接受高效抗逆转录病毒治疗，其HIV复制水平（496273±210416；34656±25332）均高于白细胞介素-6水平低的血小板减少症个体（105332±42699；19015±14296，P=0.05）。白细胞介素-6水平高的非血小板减少症患者的CD4细胞计数最高（466.7±333），病毒载量最低（63094±53300）。存在两种不同类型的HIV相关血小板减少症：一种伴有白细胞介素-6水平低，另一种白细胞介素-6呈代偿性升高。在血小板减少症个体中，后者与最差的免疫和病毒学反应相关。
