Institut National de la Santé et de la Recherche Médicale U1058, Université Montpellier 1, Montpellier, France;
Blood. 2013 Oct 24;122(17):3030-3. doi: 10.1182/blood-2012-12-470393. Epub 2013 Aug 12.
A high prevalence of monoclonal gammopathy (MG) has been observed in HIV-infected patients. We explored the conditions associated with long-term persistence of serum monoclonal protein (M protein) in HIV-infected patients on antiretroviral therapy (ART). Of 21 patients with MG, M protein disappeared in 12 patients (58%) over 5 years of ART. Higher level of serum γ-globulin and higher percentages of circulating plasmablasts and plasma cells were observed in patients with persistent MG compared with patients with transient MG. MG persistence was associated with the cumulative time of detectable plasma HIV RNA after ART initiation, detection of Epstein-Barr virus (EBV) DNA in plasma, and a high level of EBV DNA in B cells. Poor control of HIV replication and detectable EBV replication in plasma were both associated with long-term MG persistence in patients on ART. In the case of viral control, MG associated with HIV infection is usually transient.
在感染 HIV 的患者中，观察到单克隆丙种球蛋白病（MG）的高发率。我们探讨了与接受抗逆转录病毒治疗（ART）的 HIV 感染患者血清单克隆蛋白（M 蛋白）长期持续存在相关的条件。在 21 例 MG 患者中，12 例（58%）患者在 5 年的 ART 中 M 蛋白消失。与一过性 MG 患者相比，持续性 MG 患者的血清γ球蛋白水平更高，循环浆母细胞和浆细胞的比例更高。MG 持续存在与 ART 开始后可检测到的血浆 HIV RNA 的累积时间、血浆中 EBV DNA 的检测以及 B 细胞中 EBV DNA 的高水平相关。ART 患者中 HIV 复制控制不佳和血浆中可检测到 EBV 复制均与长期 MG 持续存在相关。在病毒得到控制的情况下，与 HIV 感染相关的 MG 通常是一过性的。
