Sheppard H W, Ascher M S, McRae B, Anderson R E, Lang W, Allain J P
Viral and Rickettsial Disease Laboratory, California Department of Health Services, Berkeley 94704.
J Acquir Immune Defic Syndr (1988). 1991;4(7):704-12.
A study was conducted to assess the relative contribution of the HIV-1-specific immune response and -nonspecific immune activation to HIV disease progression. The titer of antibody to the p24 core protein and the concentration of serum neopterin were measured in 238 HIV-1-seropositive subjects in a prospective cohort study of homosexual men. Antibody titers were extremely variable among cohort participants but relatively stable over time, suggesting inherent differences in the initial immune response capacity. Neopterin concentrations were also variable at cohort entry but generally increased over time. These two markers, measured at cohort entry, had powerful and independent predictive value for the development of AIDS up to 54 months before diagnosis. Subjects with low antibody titers and high levels of neopterin, had the highest incidence of AIDS (60% over 54 months). Patients with low antibody or high neopterin alone had an intermediate risk (34% incidence) and less than 10% of those with high antibody and low neopterin developed AIDS. We propose that the initial immune response to HIV and virus-mediated immune system activation are independent and innately variable components of an individual's response to HIV infection that interact to determine the clinical outcome.
开展了一项研究，以评估HIV-1特异性免疫反应和非特异性免疫激活对HIV疾病进展的相对贡献。在一项针对男同性恋者的前瞻性队列研究中，对238名HIV-1血清阳性受试者测量了p24核心蛋白抗体滴度和血清新蝶呤浓度。抗体滴度在队列参与者中差异极大，但随时间相对稳定，这表明初始免疫反应能力存在内在差异。新蝶呤浓度在队列入组时也存在差异，但总体上随时间增加。在队列入组时测量的这两个标志物，对于诊断前长达54个月的艾滋病发展具有强大且独立的预测价值。抗体滴度低且新蝶呤水平高的受试者，艾滋病发病率最高（54个月内为60%）。仅抗体低或新蝶呤高的患者具有中等风险（发病率34%），而抗体高且新蝶呤低的患者中不到10%发展为艾滋病。我们提出，对HIV的初始免疫反应和病毒介导的免疫系统激活是个体对HIV感染反应中相互独立且天生可变的组成部分，它们相互作用以决定临床结果。
