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在初治的感染HIV的既往血浆捐献者中,丙型肝炎病毒合并感染与疾病进展较慢相关。

HCV coinfection associated with slower disease progression in HIV-infected former plasma donors naïve to ART.

作者信息

Zhang Xiaoyan, Xu Jianqing, Peng Hong, Ma Yan, Han Lifeng, Ruan Yuhua, Su Bing, Wang Ning, Shao Yiming

机构信息

State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China.

出版信息

PLoS One. 2008;3(12):e3992. doi: 10.1371/journal.pone.0003992. Epub 2008 Dec 22.

Abstract

BACKGROUND

It remains controversial how HCV coinfection influences the disease progression during HIV-1 infection. This study aims to define the influence of HCV infection on the replication of HIV-1 and the disease progression in HIV-infected former plasma donors (FPDs) naïve to ART.

METHODOLOGY/PRINCIPAL FINDINGS: 168 HIV-1-infected FPDs were enrolled into a cohort study from Anhui province in central China, and thereafter monitored at month 3, 9, 15, 21 and 33. Fresh whole blood samples were used for CD4+ T-cell counting. Their plasma samples were collected and stored for quantification of HIV-1 viral loads and for determination of HCV and Toxoplasma. Out of 168 HIV-infected FBDs, 11.9% (20 cases), 80.4% (135 cases) and 7.7% (13 cases) were infected with HIV-1 alone, HIV-1/HCV and HIV/HCV/Toxoplasma, respectively. During the 33-month follow-up, only 35% (7 out of 20 cases) HIV-1 mono-infected subjects remained their CD4+ T-cell counts above 200 cells/microl and retained on the cohort study, which was significantly lower than 56% (75 out of 135 cases) for HIV/HCV group and 69% (9 out of 13 cases) for HIV/HCV/Toxoplasma group (p<0.05). CD4+ T cells in HIV mono infection group were consistently lower than that in HIV/HCV group (p = 0.04, 0.18, 0.03 and 0.04 for baseline, month 9, month 21 and month 33 visit, respectively). In accordance with those observations, HIV viral loads in HIV mono-infection group were consistently higher than that in HIV/HCV group though statistical significances were only reached at baseline (p = 0.04).

CONCLUSIONS/SIGNIFICANCE: These data indicated HCV coinfection with HIV-1 is associated with the slower disease progression at the very late stage when comparing with HIV-1 mono-infection. The coinfection of Toxoplasma with HIV and HCV did not exert additional influence on the disease progression. It will be highly interesting to further explore the underlying mechanism for this observation in the future.

摘要

背景

丙型肝炎病毒(HCV)合并感染如何影响人类免疫缺陷病毒1型(HIV-1)感染期间的疾病进展仍存在争议。本研究旨在确定HCV感染对HIV-1复制的影响以及对初治的HIV感染前血浆捐献者(FPDs)疾病进展的影响。

方法/主要发现:168例HIV-1感染的FPDs纳入中国中部安徽省的一项队列研究,随后在第3、9、15、21和33个月进行监测。采集新鲜全血样本进行CD4+T细胞计数。收集并储存他们的血浆样本,用于定量HIV-1病毒载量以及检测HCV和弓形虫。在168例HIV感染的FBDs中,仅感染HIV-1、HIV-1/HCV和HIV/HCV/弓形虫的分别占11.9%(20例)、80.4%(135例)和7.7%(13例)。在33个月的随访期间,仅35%(20例中的7例)HIV-单感染受试者的CD4+T细胞计数保持在200个/微升以上并继续留在队列研究中,这显著低于HIV/HCV组的56%(135例中的75例)和HIV/HCV/弓形虫组的69%(13例中的9例)(p<0.05)。HIV单感染组的CD4+T细胞一直低于HIV/HCV组(分别在基线、第9个月、第21个月和第33个月随访时,p值分别为0.04、0.18、0.03和0.04)。与这些观察结果一致,HIV单感染组的HIV病毒载量一直高于HIV/HCV组,尽管仅在基线时达到统计学显著性(p = 0.04)。

结论/意义:这些数据表明,与HIV-1单感染相比,HCV与HIV-1合并感染在疾病极晚期与较慢的疾病进展相关。弓形虫与HIV和HCV的合并感染对疾病进展没有额外影响。未来进一步探索这一观察结果的潜在机制将非常有趣。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0025/2602976/f90394581bb7/pone.0003992.g001.jpg

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