Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Animal Biosafety Shelter Laboratory (ABSL)-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China.
Front Immunol. 2023 Feb 9;14:1089379. doi: 10.3389/fimmu.2023.1089379. eCollection 2023.
BACKGROUND: To analyze the changing characteristics of continuous monitoring of refined lymphocyte subsets in people living with HIV/AIDS (PLWHA) during ART period. METHODS: Refined lymphocyte subsets was continuously monitored using flow cytometry for 173 PLWHA, who were hospitalized in Zhongnan Hospital of Wuhan University from August 17, 2021 to September 14, 2022. The effect of ART status and duration of ART on changes of refined lymphocyte subsets were compared in different groups. Then, the levels of refined lymphocyte subsets in PLWHA treated for more than 10 years were compared to those of 1086 healthy individuals. RESULTS: In addition to conventional CD4 T lymphocytes and CD4/CD8 ratio, gradually increasing in numbers of CD3CD4CD45RO cells, CD3CD4CD45RA cells, CD45RACD3CD4CD25CD127 and CD45ROCD3CD4CD25CD127 cells were found with the increase of ART duration. The number of CD4CD28 cells and CD8CD28 cells were 174/ul and 233/ul at 6 months post-ART, which gradually increased to 616/ul and 461/ul after ART initiation more than 10 years. Moreover, in ART ≤ 6 months, 6 months-3years, 3-10 years and >10 years groups, the percentage of CD3CD8HLADR/CD8 were 79.66%, 69.73%, 60.19% and 57.90%, respectively, and the differences between groups showed statistical significance (=5.727, =0.001). For those PLWHA with ART more than 10 years, the levels of CD4 T lymphocytes, CD3CD4CD45RO cells, CD3CD4CD45RA cells, CD4CD28 cells and CD8CD28 cells can increase to levels similar to those of healthy control. However, for those PLWHA with ART more than 10 years, CD4/CD8 ratio was 0.86 ± 0.47, which was lower than that of healthy control (0.86 ± 0.47 vs 1.32 ± 0.59, =3.611, =0.003); absolute counts and percentage of CD3CD8HLADR cells were 547/ul and 57.90%, which were higher than those of healthy control(547/ul vs 135/ul, =3.612, =0.003; 57.90% vs 22.38%, =6.959, 0.001). CONCLUSION: Persistent ART can gradually improve the immune status of PLWHA, which is manifested in the increase of lymphocytes, function recovery of lymphocytes and reduction of aberrant activation status of the immune system. After 10 years of standardized ART, most lymphocytes could return to levels of healthy persons, although it may take longer to complete recovery for CD4/CD8 ratio and CD3CD8HLADR cells.
背景：分析接受抗逆转录病毒治疗（ART）的艾滋病毒/艾滋病（HIV/AIDS）感染者（PLWHA）期间连续监测精细化淋巴细胞亚群的变化特征。
方法：对 2021 年 8 月 17 日至 2022 年 9 月 14 日在武汉大学中南医院住院的 173 例 PLWHA 连续使用流式细胞术进行精细化淋巴细胞亚群监测。比较不同组中 ART 状态和 ART 持续时间对精细化淋巴细胞亚群变化的影响，然后比较接受 ART 治疗 10 年以上的 PLWHA 与 1086 例健康个体的精细化淋巴细胞亚群水平。
结果：除了常规的 CD4 T 淋巴细胞和 CD4/CD8 比值外，随着 ART 持续时间的增加，还发现 CD3CD4CD45RO 细胞、CD3CD4CD45RA 细胞、CD45RACD3CD4CD25CD127 和 CD45ROCD3CD4CD25CD127 细胞的数量逐渐增加。ART 后 6 个月时 CD4CD28 细胞和 CD8CD28 细胞分别为 174/μl 和 233/μl，在 ART 开始 10 年以上时逐渐增加至 616/μl 和 461/μl。此外，在 ART≤6 个月、6 个月-3 年、3-10 年和>10 年组中，CD3CD8HLADR/CD8 的百分比分别为 79.66%、69.73%、60.19%和 57.90%，组间差异具有统计学意义（=5.727，=0.001）。对于那些接受 ART 治疗 10 年以上的 PLWHA，CD4 T 淋巴细胞、CD3CD4CD45RO 细胞、CD3CD4CD45RA 细胞、CD4CD28 细胞和 CD8CD28 细胞的水平可以增加到与健康对照组相似的水平。然而，对于那些接受 ART 治疗 10 年以上的 PLWHA，CD4/CD8 比值为 0.86±0.47，低于健康对照组（0.86±0.47 比 1.32±0.59，=3.611，=0.003）；CD3CD8HLADR 细胞的绝对计数和百分比分别为 547/μl 和 57.90%，高于健康对照组（547/μl 比 135/μl，=3.612，=0.003；57.90%比 22.38%，=6.959，0.001）。
结论：持续的 ART 可以逐渐改善 PLWHA 的免疫状况，表现为淋巴细胞增加、淋巴细胞功能恢复和免疫失调状态减少。经过 10 年的规范 ART，大多数淋巴细胞可恢复至健康人的水平，尽管 CD4/CD8 比值和 CD3CD8HLADR 细胞可能需要更长的时间才能完全恢复。
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