摘要
目的了解人类免疫缺陷病毒(Human immunodeficiency virus,HIV)感染者在抗逆转录病毒治疗(antiretroviral therapy,ART)中达到病毒学抑制后(病毒载量<50cp/ml)的外周血总HIV DNA水平,初步探索总HIV DNA水平及相关因素。方法纳入2019—2020年成都市在治人类免疫缺陷病毒1型(HIV-1)感染者,收集人口学和ART信息,采集乙二胺四乙酸(ethylenediaminetetraacetic acid,EDTA)抗凝全血,检测外周血总HIV DNA、病毒载量(viral load,VL)和部分T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD38^(+)CD4^(+)、CD38^(+)CD8^(+)),以总HIV DNA分组进行统计分析。结果共109人HIV-1感染者符合标准,其外周血总HIV DNA有65人低于定量下限(10cp/106细胞),44人介于10.63~223.77cp/106细胞。以定量下限分为低HIV DNA组和高HIV DNA组,在年龄、更换ART方案率、治疗前基线CD4^(+)、当前CD4^(+)、CD38^(+)CD4^(+)和VL方面,2组差异有统计学意义(t=-2.059、χ^(2)=3.922、t=3.841、t=2.869、t=2.305、U=1719.5,P<0.05)。二元logistic回归分析发现,未更换ART方案、治疗前基线CD4^(+)<200cells/μl和VL<20cp/ml在模型中差异有统计学意义(OR=0.31、6.25、6.73,P<0.05)。结论在ART达到病毒学抑制的HIV-1感染者,其外周血总HIV DNA水平有一定个体差异;不更换ART方案可能是总HIV DNA的保护因素,而治疗前基线CD4^(+)<200cells/μl和病毒载量极低拷贝(VL<20cp/ml)可能是总HIV DNA的危险因素;这些因素与外周血总HIV DNA的关系需进一步探究。
Objective To explore the related factors of total HIV DNA levels through investigating the total HIV DNA level in the peripheral blood of HIV infected patients after viral inhibition(viral load<50cp/ml)during antiretroviral therapy(ART).Methods The HIV-1 infected patients under treatment in Chengdu from 2019 to 2020 were included and their demographic and ART information were collected.EDTA anticoagulant whole blood was collected,and then total HIV DNA,viral load(VL)and partial T lymphocyte subsets(CD4^(+),CD8^(+),CD38^(+)CD4^(+),CD38^(+)CD8^(+))were analyzed.Statistical analysis was performed by grouping total HIV DNA.Results A total of 109 HIV-1 infected persons met the criteria.The total HIV DNA in peripheral blood was below the lower limit of quantification(10cp/106cells)in 65 cases,and ranged from 10.63 to 223.77cp/106cells in 44 cases.According to the lower limit of quantification,they were divided into low HIV DNA group and high HIV DNA group.There were significant differences in age,rate of ART replacement,baseline CD4^(+)before treatment,current CD4^(+),CD38^(+)CD4^(+)and VL between the two groups(t=-2.059,χ^(2)=3.922,t=3.841,t=2.869,t=2.305,U=1719.5,P<0.05).By binary logistic regression,not changing ART protocol,baseline CD4^(+)<200cells/μl and VL<20cp/ml were statistically significant in the model(OR=0.31,6.25,6.73,P<0.05).Conclusion There is a certain individual difference in the level of total HIV DNA of HIV-1 infected patients with virological suppression on AR;not changing ART protocol may be a protective factor for total HIV DNA,while baseline CD4^(+)<200cells/μl before treatment and very low viral load(<20cp/ml)are possible risk factors for total HIV DNA;the relationship between these factors and total HIV DNA in peripheral blood needs to be further explored.
作者
李姗珊
张燕琳
龚芳红
朱丹
高钰双
郭悦
LI Shanshan;ZHANG Yanlin;GONG Fanghong;ZHU Dan;GAO Yushuang;GUO Yue(Chengdu Center for Disease Control and Prevention,Chengdu,Sichuan 610041,China)
出处
《医学动物防制》
2023年第11期1043-1047,共5页
Journal of Medical Pest Control
基金
四川省卫生健康委员会科研项目(20PJ187)。
