Zhang Xue-Ying, Wang Li, Jiang Yue, Huang Si-Miao, Zhu Hong-Rui, Liu Wei, Wang Jia-Ye, Wei Xiang-Hui, Zhao Yi-Lin, Wei Wen-Juan, Fei Teng, Chen Xiao-Hong, Wang Dan, Li Jin-Liang, Ling Hong, Zhuang Min
Department of Microbiology, Harbin Medical University, Harbin, China.
Department of Infectious Diseases, Heilongjiang Provincial Hospital, Harbin, China.
BMC Infect Dis. 2025 Mar 31;25(1):443. doi: 10.1186/s12879-025-10799-5.
Currently, most people living with HIV (PLWH) in China have a strong awareness of diagnosis and treatment in the early stage of HIV infection. Subtype-specific virological and immunological features of recently infected PLWH have not yet been elucidated.
Data including CD4 count and viral load (VL) of 1508 anti-retroviral therapy (ART) -naïve PLWH were obtained from the HIV Database and comparatively analyzed among PLWH with different HIV subtypes. The infection status of 402 newly diagnosed and ART-naïve PLWH from a cohort of men who have sex with men (MSM) in China was evaluated using diagnosis records and LAg-Avidity EIA. Based on partial pol genes, HIV genotypes in 120 recent, 68 long-term, and 54 chronic infections were identified. The CD4 count, CD8 count, and VL, as well as trajectories of dynamic CD4 counts during ART of local PLWH with different HIV subtypes, were compared using non-parametric tests.
For the HIV database, the CD4 count in PLWH with CRF01_AE was lower than that in PLWH with CRF07_BC or subtype B. For the recently infected local PLWH, CRF01_AE was the dominant HIV subtype (65.83%), followed by CRF07_BC (18.33%) and subtype B (15.83%). Recent CRF01_AE infections showed a lower baseline CD4 count than CRF07_BC infections. During ART for recently infected PLWH, the CD4 count in the CRF01_AE group rapidly increased to reach a peak at the end of the first year post-ART, while the CD4 count in the CRF07_BC group increased slowly to reach a plateau at the end of the third year. The CD4 count in the subtype B group increased significantly to reach a plateau within the first two years and then its trajectory overlapped with that of the CRF07_BC group at the end of the third year post-ART.
CRF01_AE rapidly reduced CD4 count during the recent HIV infection. The CD4 count of the recently infected individuals with CRF01_AE increased sharply and reached its highest level of recovery within the first year of ART initiation. This study revealed an important time point for estimating CD4 count recovery post-ART in individuals with different HIV subtypes.
目前，中国大多数艾滋病病毒感染者（PLWH）对艾滋病病毒感染早期的诊断和治疗有较强的认识。近期感染的PLWH的亚型特异性病毒学和免疫学特征尚未阐明。
从艾滋病病毒数据库中获取1508例未接受抗逆转录病毒治疗（ART）的PLWH的CD4细胞计数和病毒载量（VL）数据，并在不同艾滋病病毒亚型的PLWH中进行比较分析。利用诊断记录和LAg-Avidity EIA评估中国一组男男性行为者（MSM）中402例新诊断且未接受ART的PLWH的感染状况。基于部分pol基因，鉴定了120例近期感染、68例长期感染和54例慢性感染中的艾滋病病毒基因型。使用非参数检验比较了不同艾滋病病毒亚型的本地PLWH在ART期间的CD4细胞计数、CD8细胞计数和VL，以及动态CD4细胞计数轨迹。
对于艾滋病病毒数据库，CRF01_AE亚型的PLWH的CD4细胞计数低于CRF07_BC亚型或B亚型的PLWH。对于近期感染的本地PLWH，CRF01_AE是主要的艾滋病病毒亚型（65.83%），其次是CRF07_BC（18.33%）和B亚型（15.83%）。近期CRF01_AE感染的基线CD4细胞计数低于CRF07_BC感染。在近期感染的PLWH接受ART期间，CRF01_AE组的CD4细胞计数迅速增加，在ART后第一年末达到峰值，而CRF07_BC组的CD4细胞计数缓慢增加，在第三年末达到平台期。B亚型组的CD4细胞计数在头两年内显著增加并达到平台期，然后在ART后第三年末其轨迹与CRF07_BC组重叠。
CRF01_AE在近期艾滋病病毒感染期间迅速降低CD4细胞计数。近期感染CRF01_AE的个体的CD4细胞计数在开始ART的第一年内急剧增加并达到最高恢复水平。本研究揭示了估计不同艾滋病病毒亚型个体ART后CD4细胞计数恢复的重要时间点。
