结核患者在抗结核治疗前后合并 HIV 感染时 T 淋巴细胞亚群和肠道蠕虫感染谱：来自埃塞俄比亚西北部贡德尔大学医院的研究

T lymphocyte subpopulations and intestinal helminthes profile among tuberculosis patients co-infected with HIV before and after anti tubercular treatment at University of Gondar Hospital, Northwest Ethiopia.

机构信息

Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Infect Dis. 2020 Feb 7;20(1):109. doi: 10.1186/s12879-020-4845-y.

DOI:10.1186/s12879-020-4845-y

PMID:32033581

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7006099/

Abstract

BACKGROUND

Tuberculosis continues to be a health problem of both developed and developing countries, and its incidence has currently increased due to HIV induced immune suppression. HIV-co-infection decreases the total number of CD4+ T cells since the virus preferentially replicates with in activated CD4+ T cells and macrophages, resulting in the disruption of granuloma to contain M. tuberculosis. In this study, we investigated the change in T lymphocyte subpopulations before and after anti-tubercular treatment and the effect of intestinal parasites on the cell populations of tuberculosis patients before the initiation of anti TB treatment.

METHOD

A prospective cohort study was conducted in the outpatient TB Clinic, University of Gondar hospital between January 2014 and August 2015. Blood samples were collected from 80 newly diagnosed TB patients with and without HIV co-infection. The mean CD4+ and CD8+ T lymphocyte counts of the patients were assessed before and after the course of anti-TB treatment. The mean values of T lymphocytes of TB, TB/HIV co-infected patients and of the control groups were compared. Data was analyzed by SPSS version 16 and the graph pad prism software.

RESULTS

A total of 80 tuberculosis patients 40 of whom were co-infected with HIV participated in our study. The mean CD4 + T lymphocytes counts of the TB/HIV cohort were 354.45 ± 138cell/μl, and the mean CD8+ cell counts were 926.82 ± 384cell/μl. There were significant changes in the mean CD4+ and CD8+ T cell counts after the course of anti-TB treatment in both groups of patients(p < 0.05). However, no statistically significant differences were observed in the mean CD4 + and CD8+ T cell counts of helminthes infected and non-infected patients (P > 0.05).

CONCLUSION

We found significantly lower CD4+ T cell counts among TB infected HIV negative patients compared with controls who showed that TB was the cause of non-HIV-associated declination of circulating CD4 counts, and the reduction was reversible with anti-tubercular treatment in both HIV-negative and ART naïve TB-HIV co-infected patients.

摘要

背景

结核病仍然是发达国家和发展中国家的一个健康问题，由于 HIV 引起的免疫抑制，其发病率目前有所增加。HIV 合并感染会导致 CD4+T 细胞总数减少，因为病毒优先在失活的 CD4+T 细胞和巨噬细胞中复制，导致肉芽肿破裂以容纳结核分枝杆菌。在这项研究中，我们研究了抗结核治疗前后 T 淋巴细胞亚群的变化，以及在开始抗 TB 治疗之前肠道寄生虫对结核患者细胞群的影响。

方法

2014 年 1 月至 2015 年 8 月，在贡德尔大学医院的门诊结核诊所进行了一项前瞻性队列研究。从 80 例新诊断的结核患者（包括 HIV 合并感染患者和未合并感染患者）中采集血样。在抗结核治疗前后评估患者的平均 CD4+和 CD8+T 淋巴细胞计数。比较结核、结核/HIV 合并感染患者和对照组的 T 淋巴细胞平均值。数据使用 SPSS 版本 16 和 Graph Pad Prism 软件进行分析。

结果

共有 80 例结核病患者（其中 40 例合并感染 HIV）参与了我们的研究。结核/HIV 组的平均 CD4+T 淋巴细胞计数为 354.45±138 个/μl，平均 CD8+细胞计数为 926.82±384 个/μl。两组患者在抗结核治疗后 CD4+和 CD8+T 细胞计数均有显著变化（均 P<0.05）。然而，在感染和未感染蠕虫的患者中，CD4+和 CD8+T 细胞计数的平均值没有统计学上的显著差异（P>0.05）。