Gruters R A, Terpstra F G, Lange J M, Roos M T, Harkema T, Mulder J W, De Wolf F, Schellekens P T, Miedema F
Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam.
AIDS. 1991 Jan;5(1):43-7. doi: 10.1097/00002030-199101000-00006.
Declining CD4+ T-cell numbers and anti-CD3-induced T-cell responsiveness are prognostic markers for progression of HIV infection. We investigated the effect of long-term (2-year) zidovudine treatment on these immunological markers in a group of nine asymptomatic p24-antigenaemic men, five of whom progressed to AIDS. A group of 10 untreated HIV-infected men, five of whom progressed to AIDS, was studied as a control. At intake, 1 year before the start of treatment, CD4+ T-cell numbers in the groups were not significantly different. However, at that time progressors already exhibited an extremely low anti-CD3-induced T-cell responsiveness compared with non-progressors. In all people T-cell responsiveness and the number of CD4+ T-cells had improved 6 months after the start of zidovudine treatment. However, CD4+ T-cell numbers were not persistently elevated, and restoration of T-cell responsiveness was of only short duration. Our results show that zidovudine treatment in the asymptomatic phase of HIV infection did not result in a sustained improvement in T-cell function. Furthermore, they suggest that differences in clinical course among zidovudine-treated asymptomatics may be caused by heterogeneity of this group with respect to T-cell functional capacity at the start of treatment.
CD4+T细胞数量的减少以及抗CD3诱导的T细胞反应性是HIV感染进展的预后标志物。我们在一组9名无症状p24抗原血症男性中研究了长期（2年）齐多夫定治疗对这些免疫学标志物的影响，其中5人进展为艾滋病。将一组10名未经治疗的HIV感染男性作为对照进行研究，其中5人进展为艾滋病。在开始治疗前1年的入组时，两组的CD4+T细胞数量无显著差异。然而，此时进展者与未进展者相比，已经表现出极低的抗CD3诱导的T细胞反应性。在所有人中，齐多夫定治疗开始6个月后，T细胞反应性和CD4+T细胞数量均有所改善。然而，CD4+T细胞数量并未持续升高，T细胞反应性的恢复也只是短暂的。我们的结果表明，在HIV感染的无症状期进行齐多夫定治疗并未导致T细胞功能的持续改善。此外，它们提示在接受齐多夫定治疗的无症状患者中临床病程的差异可能是由该组在治疗开始时T细胞功能能力的异质性所导致的。
