Bai Francesca, Tincati Camilla, Merlini Esther, Pacioni Carlotta, Sinigaglia Elisabetta, Carpani Giovanni, d'Arminio Monforte Antonella, Marchetti Giulia
Department of Medicine, Surgery and Dentistry, Clinic of Infectious Diseases and Tropical Medicine, S. Paolo Hospital, University of Milan, via A. di Rudinì, 8-20142 Milan, Italy.
AIDS Res Treat. 2012;2012:314849. doi: 10.1155/2012/314849. Epub 2011 Oct 27.
Objectives. We investigated immune phenotypes of HIV+ patients who present late, considering late presenters (LPs, CD4+ < 350/μL and/or AIDS), advanced HIV disease (AHD, CD4+ < 200/μL and/or AIDS), and AIDS presenters (AIDS-defining condition at presentation, independently from CD4+). Methods. Patients newly diagnosed with HIV at our clinic between 2007-2011 were enrolled. Mann-Whitney/Chi-squared tests and logistic regression were used for statistics. Results. 275 patients were newly diagnosed with HIV between January/2007-March/2011. 130 (47%) were LPs, 79 (29%) showed AHD, and 49 (18%) were AIDS presenters. LP, AHD, and AIDS presenters were older and more frequently heterosexuals. Higher CD8+%, lower CD127+CD4+%, higher CD95+CD8+%, CD38+CD8+%, and CD45R0+CD38+CD8+% characterized LP/AHD/AIDS presentation. In multivariate analysis, older age, heterosexuality, higher CD8+%, and lower CD127+CD4+% were confirmed associated with LP/AHD. Lower CD4+ and higher CD38+CD8+% resulted independently associated with AIDS presentation. Conclusions. CD127 downregulation and immune activation characterize HIV+ patients presenting late and would be studied as additional markers of late presentation.
目的。我们研究了就诊时已处于晚期的HIV阳性患者的免疫表型，考虑了晚期就诊者（LP，CD4 +<350/μL和/或艾滋病）、晚期HIV疾病（AHD，CD4 +<200/μL和/或艾滋病）以及艾滋病就诊者（就诊时出现艾滋病定义的病症，与CD4 +无关）。方法。纳入了2007年至2011年间在我们诊所新诊断出HIV的患者。采用Mann-Whitney/卡方检验和逻辑回归进行统计分析。结果。2007年1月至2011年3月期间有275例患者新诊断出HIV。130例（47%）为晚期就诊者，79例（29%）表现为晚期HIV疾病，49例（18%）为艾滋病就诊者。晚期就诊者、晚期HIV疾病患者和艾滋病就诊者年龄更大，更常为异性恋。较高的CD8 +%、较低的CD127 +CD4 +%、较高的CD95 +CD8 +%、CD38 +CD8 +%以及CD45R0 +CD38 +CD8 +%是晚期就诊者/晚期HIV疾病/艾滋病就诊者表现的特征。在多变量分析中，年龄较大、异性恋、较高的CD8 +%以及较低的CD127 +CD4 +%被证实与晚期就诊者/晚期HIV疾病相关。较低的CD4 +和较高的CD38 +CD8 +%被独立证实与艾滋病就诊者表现相关。结论。CD127下调和免疫激活是就诊时已处于晚期的HIV阳性患者的特征，可作为晚期就诊的额外标志物进行研究。
