Biswas Priscilla, Cozzi-Lepri Alessandro, Delfanti Fanny, Galli Andrea, Colangeli Vincenzo, Moioli Maria Cristina, Scarchilli Antonella, Abrescia Nicola, Vigevani Gianmarco, D'Arminio-Monforte Antonella, Novati Roberto, Lazzarin Adriano
Clinic of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy.
J Med Virol. 2006 Dec;78(12):1513-9. doi: 10.1002/jmv.20733.
Elevated sCD30 levels were generally associated with poor prognosis in chronic HIV infection prior to the era of highly active antiretroviral therapy (HAART). Little information is available on sCD30 and HIV-1 viremia. In this study, the association between sCD30 and HIV-1 viremia was investigated in HIV-infected patients who underwent HAART. sCD30 was measured in 276 patients prior (T0) and 6 months after HAART (T6). Standard survival analyses were used to evaluate the prognostic value of sCD30 and sCD30 change from baseline to predict the virological response to HAART. Higher levels (>30 U/ml) of sCD30 prior to HAART were associated with relatively higher viremia (P = 0.0001) and tended to be associated with a lower chance of achieving virological success (P = 0.13). The median T6 sCD30 level in patients who concomitantly had viremia >500 copies/ml was higher than the median sCD30 level of those with viremia </=500 copies/ml (P = 0.002). Conversely, within the patients who achieved viral suppression on HAART, those who had concomitantly a larger reduction in sCD30 subsequently experienced a higher rate of virological failure (P = 0.04). A strong, but complex, link exists between sCD30 levels and HIV viremia in the era of HAART. The change in sCD30 levels from pre-therapy to the date of first viral suppression could be used to identify patients who are more likely to experience later virological rebound among those who achieve initially virological success.
在高效抗逆转录病毒治疗(HAART)时代之前,慢性HIV感染患者中sCD30水平升高通常与预后不良相关。关于sCD30与HIV-1病毒血症的信息很少。在本研究中,对接受HAART的HIV感染患者中sCD30与HIV-1病毒血症之间的关联进行了调查。在276例患者HAART前(T0)和HAART后6个月(T6)测量sCD30。采用标准生存分析评估sCD30的预后价值以及从基线开始sCD30的变化,以预测对HAART的病毒学反应。HAART前sCD30水平较高(>30 U/ml)与相对较高的病毒血症相关(P = 0.0001),并且往往与实现病毒学成功的机会较低相关(P = 0.13)。病毒血症>500拷贝/ml的患者T6时sCD30水平中位数高于病毒血症≤500拷贝/ml的患者(P = 0.002)。相反,在HAART治疗实现病毒抑制的患者中,sCD30随后降低幅度较大的患者病毒学失败率较高(P = 0.04)。在HAART时代,sCD30水平与HIV病毒血症之间存在紧密但复杂的联系。从治疗前到首次病毒抑制之日sCD30水平的变化可用于识别在最初实现病毒学成功的患者中更可能出现后期病毒学反弹的患者。