Lee Eun Hwa, Lee Ki Hyun, Lee Se Ju, Kim Jinnam, Kim Jung Ho, Ahn Jin Young, Ku Nam Su, Choi Jun Yong, Yeom Joon-Sup, Jeong Su Jin
Department of Internal Medicine and AIDS Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea.
J Clin Med. 2022 Oct 14;11(20):6077. doi: 10.3390/jcm11206077.
Dehydroepiandrosterone (DHEA) is an adrenal steroid converted to potent androgens. This study aimed to discover the association between serum DHEA levels and immunologic response in people with HIV/AIDS (PLWHA). We enrolled patients aged ≥ 18 years who were treated with combination antiretroviral therapy (cART). We measured CD4+ and CD8+ T-cell counts, HIV-RNA titres, and serum DHEA levels. We assigned each patient to a good- or poor-responder group depending on their CD4+ T-cell counts at study enrolment. Participants with CD4+ T-cell counts > 200/µL were assigned to the good-responder group, whilst those with CD4+ T-cell counts < 200/µL were assigned to the poor-responder group. The participants were followed up for 2 years. The poor-responder group showed lower CD4+ T-cell counts and higher HIV PCR titres at their initial HIV diagnosis and in their 2-year follow-up data. Serum DHEA level was lower in the poor-responder group. Multivariable logistic analysis showed that BMI, initial CD4+ T-cell counts, and serum DHEA level were clinical factors associated with poor immunologic responsiveness to cART in PLWHA. Therefore, DHEA may be used as an indicator of the immunological recovery of PLWHA.
脱氢表雄酮（DHEA）是一种肾上腺类固醇，可转化为强效雄激素。本研究旨在发现血清DHEA水平与人类免疫缺陷病毒/获得性免疫综合征（HIV/AIDS）患者免疫反应之间的关联。我们纳入了年龄≥18岁且接受联合抗逆转录病毒治疗（cART）的患者。我们测量了CD4+和CD8+ T细胞计数、HIV-RNA滴度以及血清DHEA水平。根据入组时的CD4+ T细胞计数，我们将每位患者分为反应良好组或反应不佳组。CD4+ T细胞计数>200/µL的参与者被分配到反应良好组，而CD4+ T细胞计数<200/µL的参与者被分配到反应不佳组。对参与者进行了2年的随访。反应不佳组在初次HIV诊断时和2年随访数据中显示出较低的CD4+ T细胞计数和较高的HIV PCR滴度。反应不佳组的血清DHEA水平较低。多变量逻辑分析表明，BMI、初始CD4+ T细胞计数和血清DHEA水平是与HIV/AIDS患者对cART免疫反应不佳相关的临床因素。因此，DHEA可作为HIV/AIDS患者免疫恢复的指标。
