Division of Rheumatology, Department of Internal Medicine, PO Box 19063, Tygerberg Campus, Francie van Zijl Avenue, Bellville 7505, South Africa.
J Rheumatol. 2011 Jun;38(6):1055-60. doi: 10.3899/jrheum.100713. Epub 2011 Feb 15.
To determine the prevalence and specificity of anticyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) for rheumatoid arthritis (RA) in human immunodeficiency virus (HIV) infection and to evaluate the effect of immune reconstitution on these markers.
Patients with advanced HIV infection without arthritis were enrolled. CD4+ T lymphocyte counts (CD4), anti-CCP, and RF were determined before initiating antiretroviral therapy (ART) and repeated after 6 months. Results were compared to those of healthy controls. Patients were followed for the development of RA for 1 year.
Sixty patients and 26 controls were studied. Six-month followup results were available on 49 patients. Mean (SD) levels of anti-CCP were higher in patients with HIV compared to controls: respectively, 9.50 (11.41) versus 0.80 (1.32) units (p < 0.001). Mean (SD) levels decreased to 4.85 (8.12) units (p = 0.006) after 6 months of ART (HIV-infected group). Fifteen percent of patients initially tested positive for anti-CCP, 4% after 6 months versus no controls (p = 0.031). Forty-seven percent of patients initially tested positive for RF, 18% after 6 months versus 8% of controls (p < 0.001). Decreases in RF and anti-CCP after ART were accompanied by increased mean (SD) CD4: from 129 (56) to 278 (140) cells/mm(3) (p < 0.001). Anti-CCP and RF positivity was not associated with the development of RA.
Increased titers of anti-CCP and RF occur in advanced HIV infection. Although more specific than RF, before immune reconstitution, anti-CCP is an unreliable diagnostic marker for RA and does not necessarily predict future RA. After immune reconstitution, the specificity of anti-CCP approaches that of a control group.
确定抗环瓜氨酸肽抗体（抗-CCP）和类风湿因子（RF）在人类免疫缺陷病毒（HIV）感染中的类风湿关节炎（RA）患病率和特异性，并评估免疫重建对这些标志物的影响。
纳入无关节炎的晚期 HIV 感染患者。在开始抗逆转录病毒治疗（ART）之前和 6 个月后，测定 CD4+T 淋巴细胞计数（CD4）、抗-CCP 和 RF。结果与健康对照组进行比较。对患者进行了 1 年的 RA 发病情况随访。
共纳入 60 例患者和 26 例对照组，49 例患者可进行 6 个月随访。与对照组相比，HIV 患者的抗-CCP 水平较高：分别为 9.50（11.41）与 0.80（1.32）单位（p＜0.001）。接受 6 个月 ART 后，抗-CCP 水平均值（SD）降低至 4.85（8.12）单位（p=0.006）（HIV 感染组）。最初有 15%的患者抗-CCP 检测阳性，6 个月后有 4%，而对照组无阳性患者（p=0.031）。最初有 47%的患者 RF 检测阳性，6 个月后有 18%，而对照组有 8%（p＜0.001）。ART 后 RF 和抗-CCP 下降伴随着 CD4 均值（SD）的增加：从 129（56）增至 278（140）细胞/mm3（p＜0.001）。抗-CCP 和 RF 阳性与 RA 的发生无关。
晚期 HIV 感染中抗-CCP 和 RF 的滴度升高。虽然抗-CCP 比 RF 更具特异性，但在免疫重建之前，抗-CCP 不是 RA 的可靠诊断标志物，并且不一定预示未来发生 RA。免疫重建后，抗-CCP 的特异性接近对照组。
