中国广西地区 HIV/AIDS 患者在接受高效抗逆转录病毒治疗（HAART）的第一年中，T 细胞亚群的动态变化及其与口腔和全身机会性感染的关系。

Dynamics of T-cell subsets and their relationship with oral and systemic opportunistic infections in HIV/AIDS patients during the first year of HAART in Guangxi, China.

机构信息

Department of periodontics and oral medicine, College of Stomatology, Guangxi Medical University, Guangxi, China.

出版信息

J Med Virol. 2015 Jul;87(7):1158-67. doi: 10.1002/jmv.24177. Epub 2015 Mar 16.

Abstract

To analyze the dynamic changes in Th1, Th2, Tc1, and Tc2 of HIV/AIDS patients during the first year of highly active antiretroviral therapy (HAART) and to explore their relationship with oral and systemic opportunistic infections, a cohort study was carried out among HIV/AIDS patients in Guangxi, China. Ninety HIV/AIDS patients and 30 healthy controls (HC) were included. The enrolled HIV/AIDS patients were examined at baseline and after 3, 6, and 12 months of HAART. On each visit, oral and systemic opportunistic infections were recorded, oral Candida load and plasma viral load (VL) were counted, differential T-cell counts and flow cytometric analysis of T-cell subsets were performed. During the first year of HAART, the total number of opportunistic infections decreased steadily with the change in oral candidiasis (OC) most representatively. A significant Th1→Th2 switch (Th1/Th2 ratio 0.23 ± 0.12, HC 1.45 ± 0.38) and slight Tc1→Tc2 shift (Tc1/Tc2 ratio 0.93 ± 0.29, HC 1.13 ± 0.33) were found at baseline, and both received slow mitigation after HAART. LgCFU and clinical OC were correlated positively with both LgVL and clinical stage (P < 0.05) at baseline. LgCFU was also correlated positively with clinical stage at all four time points (P < 0.05). In multiple factor analysis, Th1 was confirmed to be correlated negatively with LgVL (Std.B = -0.295, P = 0.025) and LgCFU (Std.B = -0.227, P < 0.001) at baseline. After HAART, LgCFU and clinical stage were only correlated negatively with CD4 when all factors were included. These results suggest that oral candidiasis and oral Candida load could be useful clinical markers in the evaluation of HIV/AIDS patients. Th1 may play an important role against oral and systemic opportunistic infections. Tc1 and Tc2 both showed positive roles in the control of viremia without HAART. J. Med. Virol. 87:1158-1167, 2015. © 2015 Wiley Periodicals, Inc.

摘要

为分析高效抗逆转录病毒治疗（HAART）后第一年艾滋病病毒/艾滋病（HIV/AIDS）患者的 Th1、Th2、Tc1 和 Tc2 的动态变化，并探讨其与口腔和全身机会性感染的关系，在中国广西开展了一项 HIV/AIDS 患者的队列研究。共纳入 90 例 HIV/AIDS 患者和 30 例健康对照者（HC）。在基线及 HAART 后 3、6 和 12 个月时对 HIV/AIDS 患者进行检测。每次就诊时记录口腔和全身机会性感染，检测口腔白色念珠菌负荷量和血浆病毒载量（VL），进行 T 细胞计数和 T 细胞亚群流式细胞术分析。在 HAART 治疗的第一年，随着口腔念珠菌病（OC）的变化，机会性感染总数呈持续稳定下降。治疗前存在明显的 Th1→Th2 转换（Th1/Th2 比值 0.23±0.12，HC 为 1.45±0.38）和轻微的 Tc1→Tc2 转换（Tc1/Tc2 比值 0.93±0.29，HC 为 1.13±0.33），HAART 后转换速度均减慢。治疗前，lgCFU 和临床 OC 与 lgVL 和临床分期呈正相关（P<0.05）。治疗前，lgCFU 与所有四个时间点的临床分期均呈正相关（P<0.05）。多因素分析显示，Th1 与基线时 lgVL（标准 B=-0.295，P=0.025）和 lgCFU（标准 B=-0.227，P<0.001）呈负相关。HAART 后，当纳入所有因素时，lgCFU 和临床分期仅与 CD4 呈负相关。这些结果表明，口腔念珠菌病和口腔白色念珠菌负荷量可能是评估 HIV/AIDS 患者的有用临床指标。Th1 可能在口腔和全身机会性感染的控制中发挥重要作用。在没有 HAART 的情况下，Tc1 和 Tc2 均显示出控制病毒血症的积极作用。J. Med. Virol. 87:1158-1167, 2015. © 2015 Wiley Periodicals, Inc.