CD4/CD8比值作为预测接受6个月抗逆转录病毒治疗的HIV/AIDS患者发生代谢综合征的指标

CD4/CD8 Ratio as a Predictor for the Occurrence of Metabolic Syndrome in HIV / AIDS Patients During 6 Months of cART Therapy.

作者信息

Gojak Refet, Hadžiosmanović Vesna, Baljić Rusmir, Zečević Lamija, Ćorić Jozo, Mijailović Željko

机构信息

University Clinical Centre Sarajevo, Clinic for Infectious Diseases, Sarajevo, Bosnia and Herzegovina.

University Clinical Centre Sarajevo, Department of Immunology, Sarajevo, Bosnia and Herzegovina.

出版信息

J Med Biochem. 2019 Jan 22;38(4):489-495. doi: 10.2478/jomb-2018-0049. eCollection 2019 Oct.

DOI:10.2478/jomb-2018-0049

PMID:31496914

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6708296/

Abstract

BACKGROUND

HIV infection is characterized by progressive depletion of CD4 T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8 T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy.

METHODS

80 HIV/AIDS subjects were included in a retrospective case-control study. Flow cytometry was used to determine the percentage of CD4 and CD8 cells in peripheral blood of these patients. The values of biochemical parameters (triglycerides, HDL, blood sugar, blood counts), immunological parameters (CD4/CD8, PCR), anthropometric measurements and type of cART therapy were evaluated in this study.

RESULTS

After six months of cART therapy 19 (23.8%) subjects had all the elements necessary for making the diagnosis of MetS. Using multivariate analysis CD4/CD8 ratio was statistically significant (p < 0.05) and had the largest effect on development of MetS (Wald = 9.01; OR = 0.45), followed by cART (Wald = 7.87; OR = 0.10) and triglycerides (Wald = 5.27; OR = 1.7). On the other hand, body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05.

CONCLUSIONS

CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.

摘要

背景

HIV感染的特征是CD4 T细胞逐渐耗竭，原因是其合成减少且破坏增加，随后CD8 T淋巴细胞显著激活和扩增。传统上，CD4/CD8比值被描述为普通人群免疫系统衰老的标志物，但在HIV感染人群中，它越来越多地成为不同预后的标志物。本研究的主要目的是检验CD4/CD8比值在预测接受cART治疗的HIV阳性患者发生代谢综合征（MetS）方面的作用。

方法

80名HIV/AIDS受试者被纳入一项回顾性病例对照研究。采用流式细胞术测定这些患者外周血中CD4和CD8细胞的百分比。本研究评估了生化参数（甘油三酯、高密度脂蛋白、血糖、血细胞计数）、免疫参数（CD4/CD8、PCR）、人体测量指标和cART治疗类型的值。

结果

经过六个月的cART治疗，19名（23.8%）受试者具备了做出MetS诊断所需的所有要素。使用多变量分析，CD4/CD8比值具有统计学意义（p < 0.05），并且对MetS的发生影响最大（Wald = 9.01；OR = 0.45），其次是cART（Wald = 7.87；OR = 0.10）和甘油三酯（Wald = 5.27；OR = 1.7）。另一方面，cART治疗六个月后，体重和腰围对MetS的发生没有统计学意义上的显著影响，p > 0.05。