不同临床分期 HIV-1感染者／AIDS 患者血样的蛋白印迹试验带型分析

摘要

目的：分析各临床分期的人类免疫缺陷病毒1型（HIV-1）感染者／获得性免疫缺陷综合征（AIDS）患者血清中病毒蛋白抗体的变化，探讨不同临床分期的 HIV-1感染者／AIDS 患者蛋白印迹试验（WB）的带型特点。方法对汕头市2009至2012年确证的部分 HIV-1抗体阳性病例进行 CD4＋T 细胞计数，根据计数结果对病例进行分组：原发感染期组（CD4＋≥500／mm3）；感染中期组（CD4＋≥200／mm3且＜500／mm3）；AIDS 期组（CD4＋＜200／mm3）；对各组的 WB 结果进行病毒蛋白（p17、p24、p31、p39、gp41、p51、p55、p66、gp120、gp160）抗体的阳性率统计以及带型分析。结果病毒蛋白 p24、p31、gp41、p51、p66、gp120和 gp160的抗体阳性率较高（总阳性率分别为98．2％、92．0％、90．8％、89．5％、93．3％、98．7％和97．5％），且在3个分期组间未见明显变化（P ＞0．05）；病毒蛋白 p17、p39和 p55呈现较低的抗体阳性率（总阳性率分别为68．9％、49．1％和42．5％）；蛋白 p17的阳性率从原发感染期的91．5％降为感染中期的62．8％（P ＜0．01）及 AIDS 期59．3％（P ＜0．01）；WB 结果中的全带型、缺失 p39＋p55和缺失 p17＋p39＋p55的带型是3个疾病分期组患者的常见带型；在3个分期组中，原发感染期中全带型出现率最高（60．8％），而缺失 p17＋p39＋p55的出现率最低（6．5％）。结论病毒蛋白 p17抗体的阴转可以作为疾病从原发感染期进入感染中期／AIDS 期的一个潜在判别指标。%Objective To analyze the change of anti-virus antibodies in serum of patients with different clinical stages of human immunodeficiency virus 1 (HIV-1 )infection/acquired immune deficiency syndrome (AIDS),and to investigate the band pattern characteristics of Western blotting (WB).Methods CD4 + T cell counting was determined in the part of HIV-1 confirmed cases in Shantou from 2009 to 201 2.According to the results,these cases were classified into 3 groups,primary-stage infection group (CD4 +≥500 /mm3 ),middle-stage infection group (CD4 +≥ 200 /mm3 and CD4 + <500 /mm3 )and AIDS group (CD4 + <200 /mm3 ).The WB results of the 3 groups were analyzed and performed to determine the positive rates of antibodies against viral proteins (p1 7,p24,p31 ,p39,gp41 ,p51 ,p55, p66,gp1 20 and gp1 60)and the band patterns of WB.Results The antibodies against viral protein p24,p31 ,gp41 , p51 ,p66,gp1 20 and gp1 60 showed high total positive rates (98.2%,92.0%,90.8%,89.5%,93.3%,98.7%and 97.5%,respectively),while the positive rates had no obvious difference among the 3 stages (P >0.05).The antibodies against viral proteins p1 7,p39 and p55 showed low positive rates (68.9%,49.1 % and 42.5%, respectively).The positive rate of protein p1 7 showed an obvious declining between primary-stage infection groups (91 .5%)and middle-stage infection group 62.8% (P <0.01 )as well as AIDS group 59.3% (P <0.01 ).All bands, missing p39 +p55 and missing p1 7 +p39 +p55 were the common band patterns of WB among the 3 groups.Primary-stage infection group showed the highest appearance rate (60.8%)of all bands but the lowest appearance rate (6.5%) of missing p1 7 +p39 +p55.Conclusions Turning negative of antibody against viral protein p1 7 could be used as a potential distinguish parameter to forecast the disease progression of HIV-1 from primary-stage infection to middle-stage infection group /AIDS group.