Miró J M, Buira E, Mallolas J, Gallart T, Moreno A, Zamora L, Vilella R, Gatell J M, Soriano E
Servicio de Enfermedades Infecciosas, Hospital Clínic i Provincial, Universidad de Barcelona.
Med Clin (Barc). 1994 Apr 23;102(15):566-70.
The CD4+ lymphocytes are the principal target cell for the human immunodeficiency virus (HIV). Their depletion originates a very severe cell immunosuppression, which conditions the appearance of opportunistic infections and neoplasms characteristic of AIDS. The aim of this study was to evaluate whether there is a relation between the degree of cell immunosuppression and the type of opportunistic infections and neoplasms which these patients develop in Spain.
The CD4+ lymphocyte counts in 400 adults with HIV infection who developed opportunistic infections or neoplasms were retrospectively reviewed (1987-1991). This determination was carried out during between two months prior to diagnosis of AIDS (CDC, 1987) to one month after such diagnosis.
The results allowed opportunistic infections to be classified into three groups according to the grade of immunosuppression: 1) opportunistic infections with more than 0.2 x 10(9) CD4+ lymphocytes/l (45-60% of cases of tuberculosis, esophageal candidiasis and enteritis by Isospora belli); 2) opportunistic infections with 0-0.2 x 10(9) CD4/l (87-100% of the cases of pneumonia by Pneumocystis carinii, encephalic toxoplasmosis, visceral leishmaniasis and enteritis by Cryptosporidium); 3) opportunistic infections with 0-0.1 x 10(9) CD4 lymphocytes/l (70-100% of the cases of systemic cryptococcosis, retinitis by cytomegalovirus, progressive multifocal leukoencephalopathy and infection by Mycobacterium avium-intracellulare). With respect to the neoplasms, Kaposi's sarcoma was observed in patients with different degrees of immunosuppression. Seventy-five and 80% of the patients with non Hodgkin's lymphoma and primary cerebral lymphoma had less than 0.2 x 10(9)/l and less than 0.1 x 10(9)/l CD4+ lymphocytes, respectively.
The CD4 lymphocyte counts may predict the type of opportunistic infections which patients with the human immunodeficiency virus infection may develop.
CD4+淋巴细胞是人类免疫缺陷病毒（HIV）的主要靶细胞。其耗竭会引发非常严重的细胞免疫抑制，这导致了艾滋病特有的机会性感染和肿瘤的出现。本研究的目的是评估细胞免疫抑制程度与西班牙这些患者所发生的机会性感染和肿瘤类型之间是否存在关联。
回顾性分析了400例发生机会性感染或肿瘤的HIV感染成人患者的CD4+淋巴细胞计数（1987 - 1991年）。该测定在艾滋病诊断（疾病控制与预防中心，1987年）前两个月至诊断后一个月期间进行。
结果允许根据免疫抑制程度将机会性感染分为三组：1）CD4+淋巴细胞计数超过0.2×10⁹/升时发生的机会性感染（45 - 60%的肺结核、食管念珠菌病和贝氏等孢球虫肠炎病例）；2）CD4计数为0 - 0.2×10⁹/升时发生的机会性感染（87 - 100%的卡氏肺孢子虫肺炎、脑弓形虫病、内脏利什曼病和隐孢子虫肠炎病例）；3）CD4淋巴细胞计数为0 - 0.1×10⁹/升时发生的机会性感染（70 - 100%的系统性隐球菌病、巨细胞病毒性视网膜炎、进行性多灶性白质脑病和鸟分枝杆菌 - 胞内分枝杆菌感染病例）。关于肿瘤，在不同免疫抑制程度的患者中均观察到了卡波西肉瘤。非霍奇金淋巴瘤和原发性脑淋巴瘤患者中，分别有75%和80%的患者CD4+淋巴细胞计数低于0.2×10⁹/升和低于0.1×10⁹/升。
CD4淋巴细胞计数可预测人类免疫缺陷病毒感染患者可能发生的机会性感染类型。
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