未经抗病毒治疗的HIV/AIDS患者CD8+ T细胞HLA-DR、 CD38表达水平与CD4+ T细胞计数的相关性研究

摘要

Objective To analyze the correlation between CD4+ T cell count and HLA-DR or CD38 expression on peripheral CD8+ T cells in treatment-naive Chinese HIV/AIDS patients.Methods A total of 471 treatment-naive HIV-infected patients and 53 healthy volunteers were enrolled.HLA-DR or CD38 expression on peripheral CD8+ T cells, CD4+ T cell count, naive CD4+ T cell subsets and CD28 expression on T cells were measured by flow cytometry.Plasma HIV RNA load was quantified by real-time PCR (COBAS TaqMan RT-PCR).Mann-Whitney U test and Spearman's rank correlation test were used for statistical analysis.Results CD38 expression intensity on CD8+ T cells was negatively correlated with CD4+ T cell count (r =-0.53, P ＜ 0.001) and naive CD4+ T cell count (r =-0.48, P ＜ 0.001).CD38 expression on CD8+ T cells also displayed significantly negative correlation with CD28 expression on CD8+ T cells (r =-0.46, P ＜ 0.001).HLA-DR expression on CD8+ T cells did not show significant correlation with CD4+ T cell count.Only weak positive correlation was found between CD38 intensity on CD8+ T cells and plasma HIV RNA load.Conclusions Compared with HLA-DR, CD38 expression on CD8+ T cells shows more significant negative correlation with CD4+ T cell count in treatment-naive patients.CD38 and HLA-DR may play different roles on the persistent immune activation in HIV infection.%目的 探讨CD8 T细胞HLA-DR、CD38表达水平与CD4+T细胞计数的相关性,了解不同激活标记物的作用,深化对艾滋病发病机制的认识.方法 招募471例未接受过抗病毒治疗的HIV/AIDS患者,采集外周静脉血标本,经流式细胞术检测CD8+T细胞表面HLA-DR、CD38的表达水平,分析其与CD4+ T细胞计数、纯真CD4+T细胞计数及T细胞第二信号受体CD28表达比例的相关性.结果 CD8+ T细胞的CD38表达比例与CD4+ T细胞计数之间呈现显著负相关(r=-0.53,P＜0.001),与纯真CD4+ T细胞计数之间也呈现显著负相关(r=-0.48,P＜0.001),与CD8+T细胞的第二信号受体CD28表达比例存在显著负相关(r=-0.46,P＜0.000 1).未发现CD8+T细胞的HLA-DR表达比例与CD4 T细胞及其纯真亚群计数之间存在显著相关性.结论 以CD38表达水平为指标的免疫激活与CD4 T细胞计数的相关性优于HLA-DR,CD8+ T细胞表面CD38表达水平越高,CD4+ T细胞计数越低且功能障碍越严重,CD38和HLA-DR在免疫激活当中可能发挥不同的作用,其机制值得进一步研究.