Xue Xiujuan, Tian Suian, Zhu Qian, Sun Dingyong, Wang Zhe
Center for AIDS/STD Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Feb;50(2):143-7. doi: 10.3760/cma.j.issn.0253-9624.2016.02.008.
To investigate the progression and drug resistance of long-term non-progressors during three follow-up in Henan province.
In May 2009, 26 cases of long-term non-progressors were recruited who infected HIV more than 10 years with blood collection and supply routes, did not receive anti-retroviral therapy, CD4(+)T lymphocyte count ≥350/μl and did not show typical symptoms of AIDS from Weishi, Shangcai, and Linying of Henan Province. Continuous follow-up were conducted three times since 2009 every two years with cohort analysis, the epidemiological information of infection routes, infection time and blood were collected, and 78 parts of 10 ml EDTA anticoagulated whole blood were collected. The changes of CD4 (+) T lymphocytes, viral load, and virus gene variety were characterized from 2009 to 2014. In-house methods were used to explore primary drug resistance of long-term non-progressors. Nonparametric Kruskal-Wallis test were used to compare CD4(+) T lymphocyte count and viral load changes during different follow-up times.
The average age and infection time of 26 cases were (48.51 ± 6.75) years, (13.42 ± 4.26) years, respectively. Three follow-up times, CD4(+) T lymphocyte count P50 (P25-P75) was 573.5 (487.4-789.8), 499.8 (403.5-635.7), and 418.8 (297.6-537.8)/μl (H=63.99,P<0.001), respectively. And natural logarithm of viral load P50 (P25-P75) were 3.93 (3.43-4.55), 4.29 (3.78-4.75), 4.50 (4.01-4.81) (H=3.19,P=0.355), respectively. Subtype and phylogenetic analysis of HIV showed that prevalent cases were B subtype, accounting for 88.5% (23/26), and three cases showed restructuring changes. Two cases appeared highly resistant of 18 infected patients whose viral load >1 000 copies/ml.
The CD4(+)T lymphocyte had a declining trend, virus subtype recombinant changes in a few cases, and primary drug resistance was found of long-term non-progressors in Henan province.
探讨河南省长期不进展者在三次随访期间的疾病进展及耐药情况。
2009年5月，招募了26例长期不进展者，这些患者通过血液采集和供应途径感染HIV超过10年，未接受抗逆转录病毒治疗，CD4(+)T淋巴细胞计数≥350/μl，且无典型艾滋病症状，来自河南省尉氏、上蔡和临颍。自2009年起每两年进行一次连续三次随访并进行队列分析，收集感染途径、感染时间及血液的流行病学信息，采集78份10ml乙二胺四乙酸抗凝全血。对2009年至2014年期间CD4(+)T淋巴细胞、病毒载量及病毒基因多样性的变化进行特征分析。采用内部方法探索长期不进展者的原发性耐药情况。采用非参数Kruskal-Wallis检验比较不同随访时间的CD4(+)T淋巴细胞计数和病毒载量变化。
26例患者的平均年龄和感染时间分别为(48.51±6.75)岁、(13.42±4.26)年。三次随访时，CD4(+)T淋巴细胞计数的P50(P25-P75)分别为573.5(487.4-789.8)、499.8(403.5-635.7)和418.8(297.6-537.8)/μl(H=63.99，P<0.001)。病毒载量的自然对数P50(P25-P75)分别为3.93(3.43-4.55)、4.29(3.78-4.75)、4.50(4.01-4.81)(H=3.19，P=0.355)。HIV的亚型及系统发育分析显示，流行毒株为B亚型，占88.5%(23/26)，3例出现重组变化。18例病毒载量>1000拷贝/ml的感染者中，2例出现高度耐药。
河南省长期不进展者的CD4(+)T淋巴细胞呈下降趋势，少数病例出现病毒亚型重组变化，并发现原发性耐药情况。
