N'Gom P T, Jaffar S, Ricard D, Wilkins A, Ariyoshi K, Morgan G, Da Silva A P, Whittle H C
Medical Research Council Laboratories, Banjul, The Gambia, West Africa.
Br J Biomed Sci. 1997 Dec;54(4):251-5.
Co-infections such as Mycobacterium tuberculosis (TB) and Pneumocystis pneumonia may affect the progress of HIV infection and speed the onset of death. As malaria and syphilis are both endemic in West Africa we examined their effects on HIV-2 infection, for these may also accelerate the progress of disease. A community-based case-control study was undertaken in a rural village in Guinea-Bissau, West Africa. One hundred and fifty asymptomatic subjects seropositive for HIV-2 and 154 age- and sex-matched controls were enrolled. Venous blood samples taken into EDTA were stained within six hours of collection with CD4 and CD8 monoclonal antibodies and processed by Q-Prep machine in the field. The stained cells were then transported on ice by road and analysed by FACS-can at the base laboratory in The Gambia within a week. The mean CD4% was significantly lower and geometric mean neopterin and beta 2-microglobulin levels were significantly higher in the HIV-2-infected subjects than in the controls (P < 0.01 for all cases versus all controls). The mean CD4% was lower and beta 2-microglobulin level was higher in both HIV-2 and control subjects with active or past syphilis when compared with subjects with no syphilis; however, syphilis did not have a marked effect on plasma neopterin level. Malaria infection raised neopterin levels, but had little effect on CD4%. Overall multiple regression analysis allowing for HIV-2 infection and other variables showed that syphilis lowered CD4% (P = 0.01) and raised beta 2-microglobulin levels (P = 0.05) and malaria raised neopterin levels (P = 0.05). The conclusions are that HIV-2 infection is associated with lower CD4% and higher neopterin and beta 2-microglobulin levels than controls, and co-infection with syphilis is associated with a further lowering of CD4%, suggesting a worse suppression of the immune system. Co-infection with malaria is associated with a modest immune disturbance.
诸如结核分枝杆菌（TB）和肺孢子菌肺炎等合并感染可能会影响HIV感染的进程并加速死亡的发生。由于疟疾和梅毒在西非均为地方病，我们研究了它们对HIV-2感染的影响，因为这些感染也可能加速疾病的进展。在西非几内亚比绍的一个乡村开展了一项基于社区的病例对照研究。招募了150名HIV-2血清学阳性的无症状受试者以及154名年龄和性别匹配的对照。采集到乙二胺四乙酸（EDTA）抗凝管中的静脉血样本在采集后6小时内用CD4和CD8单克隆抗体进行染色，并在现场用Q-Prep仪器处理。然后将染色后的细胞通过公路在冰上运输，并在一周内于冈比亚的基础实验室用流式细胞仪（FACS）进行分析。与对照组相比，HIV-2感染受试者的平均CD4%显著降低，新蝶呤和β2-微球蛋白的几何平均水平显著升高（所有病例与所有对照相比，P<0.01）。与无梅毒的受试者相比，患有活动性或既往梅毒的HIV-2感染受试者和对照受试者的平均CD4%较低，β2-微球蛋白水平较高；然而，梅毒对血浆新蝶呤水平没有显著影响。疟疾感染会升高新蝶呤水平，但对CD4%影响较小。综合考虑HIV-2感染及其他变量的多元回归分析表明，梅毒会降低CD4%（P=0.01）并升高β2-微球蛋白水平（P=0.05），而疟疾会升高新蝶呤水平（P=0.05）。结论是，与对照组相比，HIV-2感染与较低的CD4%以及较高的新蝶呤和β2-微球蛋白水平相关，与梅毒合并感染会导致CD4%进一步降低，提示免疫系统抑制更严重。与疟疾合并感染与适度的免疫紊乱有关。
