Whittle H, Egboga A, Todd J, Morgan G, Rolfe M, Sabally S, Wilkins A, Corrah T
MRC Laboratories, Fajara, The Gambia.
Clin Exp Immunol. 1993 Jul;93(1):45-50. doi: 10.1111/j.1365-2249.1993.tb06495.x.
This study describes a broad spectrum of cellular and antibody-mediated immune responses found in 28 asymptomatic and 37 symptomatic Gambian patients with HIV-2 infection. It shows that these responses vary according to the stage of infection as described by three clinical staging systems. The first system was a local one based on the signs used for the WHO Bangui clinical definition of AIDS, the second, suggested by WHO, was based on a performance scale, and the third was that used by the Centre for Disease Control. Asymptomatic patients had significantly lower mean CD4 counts, lymphoproliferative and interferon-gamma (IFN-gamma) responses and lower IgG and IgM antibody responses to keyhole limpet haemocyanin (KLH) than controls. These measurements and the size of the skin test reaction to purified protein derivative (PPD) or Candida antigen declined significantly according to the stage of infection. Mean values of the serological markers beta 2-microglobulin and neopterin and antibody titres to Epstein-Barr virus capsid antigen (EBVCA) rose significantly according to severity of disease. The Gambian or WHO clinical staging systems, which are easy and cheap to apply, may serve as an alternative to sophisticated and expensive immunological measurements when trying to stage disease and predict prognosis.
本研究描述了在28例无症状和37例有症状的HIV-2感染冈比亚患者中发现的广泛的细胞免疫和抗体介导的免疫反应。结果表明，这些反应根据三种临床分期系统所描述的感染阶段而有所不同。第一种系统是基于用于世界卫生组织班吉艾滋病临床定义的体征的局部系统，第二种是世界卫生组织建议的基于表现量表的系统，第三种是疾病控制中心使用的系统。无症状患者的平均CD4细胞计数、淋巴细胞增殖和干扰素-γ（IFN-γ）反应显著低于对照组，对钥孔戚血蓝蛋白（KLH）的IgG和IgM抗体反应也较低。这些测量结果以及对纯化蛋白衍生物（PPD）或念珠菌抗原的皮肤试验反应大小根据感染阶段显著下降。血清学标志物β2-微球蛋白和新蝶呤的平均值以及针对爱泼斯坦-巴尔病毒衣壳抗原（EBVCA）的抗体滴度根据疾病严重程度显著升高。冈比亚或世界卫生组织的临床分期系统应用简便且成本低廉，在试图对疾病进行分期和预测预后时，可作为复杂且昂贵的免疫学测量的替代方法。
