C 反应蛋白升高与 HIV-1 母婴传播相关。
Elevation of cervical C-X-C motif chemokine ligand 10 levels is associated with HIV-1 acquisition in pregnant and postpartum women.
机构信息
Department of Medicine.
Department of Global Health.
出版信息
AIDS. 2020 Oct 1;34(12):1725-1733. doi: 10.1097/QAD.0000000000002613.
OBJECTIVE
To evaluate the relationship between cervical cytokine/chemokine concentrations and HIV-1 acquisition in peripartum Kenyan women.
DESIGN
Nested case-control study.
METHODS
Women participating in a prospective study of peripartum HIV acquisition in Kenya (the Mama Salama Study), were tested for HIV-1 at 1-3 month intervals during pregnancy and through 9 months postpartum. Cases positive for HIV-1 RNA during follow-up (N = 14), were matched 3 : 1 with HIV-negative controls (N = 42) based on age, marital status, partner HIV-1 status, transactional sex, and timing of cervical swab collection. Concentrations of five cytokines (IL-1β, IL-6, IL-10, IFNγ, and TNFα) and four chemokines (IL-8, C-X-C motif chemokine ligand 10 (CXCL10), macrophage inflammatory protein-1 α, and macrophage inflammatory protein-1 β) were measured from cervical swabs collected at the visit prior to HIV-1 diagnosis (cases) or matched gestational/postpartum time (controls). Cytokine/chemokine concentrations were compared between cases and controls using Wilcoxon rank-sum tests. Principal component analysis was used to create a summary score for closely correlated cytokines/chemokines. Associations with HIV-1 acquisition were analyzed using conditional logistic regression. Path analysis was used to evaluate hypothesized relationships between CXCL10, vaginal washing, Nugent score, and HIV-1 acquisition.
RESULTS
Conditional logistic regression analysis demonstrated an association between increased concentrations of CXCL10 and HIV-1 acquisition (odds ratio = 1.74, 95% confidence interval 1.04, 2.93; P = 0.034). Path analysis confirmed a positive independent association between higher concentrations of CXCL10 and HIV-1 acquisition (path coefficient = 0.37, 95% confidence interval 0.15, 0.59; P < 0.001).
CONCLUSION
HIV-1 acquisition was associated with increased cervical concentrations of CXCL10 in pregnant and postpartum women.
目的
评估围产期肯尼亚女性宫颈细胞因子/趋化因子浓度与 HIV-1 感染之间的关系。
设计
巢式病例对照研究。
方法
参与肯尼亚围产期 HIV-1 感染前瞻性研究（Mama Salama 研究）的女性，在妊娠期间每隔 1-3 个月、产后 9 个月进行 HIV-1 检测。随访期间 HIV-1 RNA 阳性的病例（N=14），按照年龄、婚姻状况、性伴侣 HIV-1 状况、商业性性行为和宫颈拭子采集时间，与 HIV-1 阴性对照（N=42）3：1 配对。在 HIV-1 诊断前（病例）或匹配的妊娠/产后时间（对照）采集的宫颈拭子中，测量了五种细胞因子（IL-1β、IL-6、IL-10、IFNγ和 TNFα）和四种趋化因子（IL-8、C-X-C 基序趋化因子配体 10（CXCL10）、巨噬细胞炎性蛋白-1α和巨噬细胞炎性蛋白-1β）的浓度。使用 Wilcoxon 秩和检验比较病例和对照组之间细胞因子/趋化因子的浓度。使用条件逻辑回归分析评估与 HIV-1 感染相关的关联。路径分析用于评估 CXCL10、阴道冲洗、Nugent 评分和 HIV-1 感染之间的假设关系。
结果
条件逻辑回归分析表明，CXCL10 浓度升高与 HIV-1 感染相关（比值比=1.74，95%置信区间 1.04，2.93；P=0.034）。路径分析证实，较高的 CXCL10 浓度与 HIV-1 感染之间存在正相关的独立关联（路径系数=0.37，95%置信区间 0.15，0.59；P<0.001）。
结论
在妊娠和产后妇女中，CXCL10 浓度的增加与 HIV-1 感染相关。
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