诊断时的HIV RNA/DNA水平可预测免疫重建：一项纵向分析。

HIV RNA/DNA Levels at Diagnosis Can Predict Immune Reconstitution: A Longitudinal Analysis.

作者信息

Basoulis Dimitrios, Pantazis Nikos, Paraskevis Dimitrios, Iliopoulos Panos, Papadopoulou Martha, Akinosoglou Karolina, Hatzakis Angelos, Daikos George L, Psichogiou Mina

机构信息

1st Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

出版信息

Microorganisms. 2023 Jun 6;11(6):1510. doi: 10.3390/microorganisms11061510.

DOI:10.3390/microorganisms11061510

PMID:37375012

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10300907/

Abstract

BACKGROUND

HIV DNA mirrors the number of infected cells and the size of the HIV viral reservoir. The aim of this study was to evaluate the effect of pre-cART HIV DNA levels as a predictive marker of immune reconstitution and on the post-cART CD4 counts trends.

METHODS

HIV DNA was isolated from PBMCs and quantified by real-time PCR. Immune reconstitution was assessed up to four years. Piecewise-linear mixed models were used to describe CD4 count changes.

RESULTS

148 people living with HIV (PLWH) were included. The highest rate of immune reconstitution was observed during the first trimester. There was a trend showing that high HIV RNA level resulted in greater increase in CD4 count, especially during the first trimester of cART (difference above vs. below median 15.1 cells/μL/month; 95% CI -1.4-31.5; = 0.073). Likewise, higher HIV DNA level would predict greater CD4 increases, especially after the first trimester (difference above vs. below median 1.2 cells/μL/month; 95% CI -0.1-2.6; = 0.071). Higher DNA and RNA levels combined were significantly associated with greater CD4 increase past the first trimester (difference high/high vs. low/low 2.1 cells/μL/month; 95% CI 0.3-4.0; = 0.024). In multivariable analysis, lower baseline CD4 counts predicted a greater CD4 rise.

CONCLUSIONS

In successfully treated PLWH, pre-cART HIV DNA and HIV RNA levels are predictors of immune reconstitution.

摘要

背景

HIV DNA反映了受感染细胞的数量以及HIV病毒库的大小。本研究的目的是评估cART前HIV DNA水平作为免疫重建预测指标的效果以及对cART后CD4计数趋势的影响。

方法

从外周血单核细胞（PBMCs）中分离HIV DNA，并通过实时PCR进行定量。对免疫重建进行了长达四年的评估。采用分段线性混合模型来描述CD4计数的变化。

结果

纳入了148名HIV感染者（PLWH）。在孕早期观察到最高的免疫重建率。有一个趋势表明，高HIV RNA水平导致CD4计数增加幅度更大，尤其是在cART的孕早期（中位数以上与以下的差异为15.1个细胞/μL/月；95%CI -1.4 - 31.5；P = 0.073）。同样，较高的HIV DNA水平可预测更大的CD4增加，尤其是在孕早期之后（中位数以上与以下的差异为1.2个细胞/μL/月；95%CI -0.1 - 2.6；P = 0.071）。DNA和RNA水平都较高与孕早期之后更大的CD4增加显著相关（高/高与低/低的差异为2.1个细胞/μL/月；95%CI 0.3 - 4.0；P = 0.024）。在多变量分析中，较低的基线CD4计数预测CD4上升幅度更大。