Wachtman Lynn M, Tarwater Patrick M, Queen Suzanne E, Adams Robert J, Mankowski Joseph L
Department of Comparative Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205-2196, USA.
J Neurovirol. 2006 Feb;12(1):25-33. doi: 10.1080/13550280500516484.
As the prevalence of human immunodeficiency virus (HIV)-induced central nervous system (CNS) disease has increased with antiretroviral treatment, there is a critical need for identifying biomarkers that predict HIV CNS disease. To identify novel hematologic markers that precede and predict CNS disease, the authors examined longitudinal hematology data from 47 simian immunodeficiency virus (SIV)-infected macaques. This study demonstrated that the magnitude of decline in circulating platelet counts beginning at day 28 post infection, during asymptomatic SIV infection, predicted the eventual development of SIV encephalitis. Univariate analysis performed on platelet values obtained day 56 post inoculation demonstrated that SIV-infected macaques with the greatest decline in platelet numbers were 18 times more likely to develop SIV CNS disease than SIV-infected animals with minimal to no decline in circulating platelet counts. Decline in platelet number was a more robust marker than decline in hemoglobin levels, a previously identified marker of HIV CNS disease. The identification of an association between decline in platelets and the development of encephalitis demonstrates that monitoring platelet decline in HIV-infected individuals may serve as a predictive marker for clinical progression to HIV-induced CNS disease. Identifying those HIV-infected individuals at risk for CNS disease during asymptomatic stages of infection would promote early interventive, neuroprotective therapy to prevent neuronal damage and loss.
随着抗逆转录病毒治疗的应用，人类免疫缺陷病毒（HIV）所致中枢神经系统（CNS）疾病的患病率有所上升，因此迫切需要鉴定能够预测HIV中枢神经系统疾病的生物标志物。为了鉴定在中枢神经系统疾病之前出现并可预测该病的新型血液学标志物，作者检查了47只感染猿猴免疫缺陷病毒（SIV）的猕猴的纵向血液学数据。这项研究表明，在无症状SIV感染期间，感染后第28天开始循环血小板计数下降的幅度可预测SIV脑炎的最终发展。对接种后第56天获得的血小板值进行单变量分析表明，血小板数量下降最大的SIV感染猕猴发生SIV中枢神经系统疾病的可能性是循环血小板计数极少下降或未下降的SIV感染动物的18倍。血小板数量下降是比血红蛋白水平下降更强有力的标志物，血红蛋白水平下降是先前确定的HIV中枢神经系统疾病的标志物。血小板下降与脑炎发展之间关联的确定表明，监测HIV感染个体的血小板下降情况可作为HIV所致中枢神经系统疾病临床进展的预测标志物。识别出在感染无症状阶段有患中枢神经系统疾病风险的HIV感染个体，将促进早期干预性神经保护治疗，以防止神经元损伤和丧失。
