HIV感染和AIDS患者T淋巴细胞免疫病理改变的研究

目的　探讨我国HIV感染和AIDS患者T淋巴细胞的免疫病理改变情况及其临床意义。方法　收集 13例HIV感染患者 (HIV组 )、2 7例AIDS患者 (AIDS组 )和 5 1名健康献血员 (正常对照组 )的抗凝血 ,用人T淋巴细胞亚群的特异性荧光抗体标记 ,通过流式细胞仪检测外周血CD4 + T淋巴细胞 (T4细胞 )、CD8+ T淋巴细胞 (T8细胞 )及其亚群 ,并检测患者血浆HIV载量。结果　正常对照组、HIV组和AIDS组外周血T4细胞计数 (× 10 6个 /L)分别为 84 9± 2 88,4 37± 184 ,5 0± 5 1,组间比较P <0 0 1;T8细胞计数 (× 10 6个 /L)分别为 5 79± 175 ,10 31± 345 ,5 35± 338,HIV组明显高于正常对照组(P <0 0 5 ) ;T4纯真细胞 (CD4 + CD4 5RA+ CD6 2L+ )亚群比例分别为 4 3 0 %± 11 4 % ,4 4 2 %± 12 8% ,2 4 8%± 15 5 % ,AIDS组明显为低 (P <0 0 5 ) ;T4纯真细胞计数 (× 10 6个 /L)分别为 36 8± 16 2 ,185±134,18± 2 0 ,组间比较P <0 0 1;T4功能细胞 (CD4 + CD2 8+ )亚群比例分别为 93 1%± 8 1% ,6 2 6 %±2 8 2 % ,5 6 9%± 2 6 4 % ,组间比较P <0 0 1;T4和T8激活细胞 (CD4 + HLA DR+ ,CD8+ HLA DR+ ,CD8+CD38+ )亚群比例均表现为AIDS组 >HIV组 >正常对照组 (P <0 0 5 ) ;T4和T8凋亡细胞 (CD4 +CD95 + ,C

T-lymphocyte immune in HIV-infected people and AIDS patients in China

OBJECTIVE: To study the T-lymphocyte immune alterations and its clinical significance in HIV-infected persons and AIDS patients in China. METHODS: Peripheral blood samples were collected from 13 HIV-infected persons, 27 AIDS patients, and 51 healthy blood donors (controls) and then labeled with monoclonal antibodies. Flow cytometry was used to detect the count of CD4(+) T-lymphocytes, CD8(+) T-lymphocytes, and its different subsets including the naive cell subset (CD4(+) CD45RA(+) CD62L(+)), activated cell subsets (CD4(+) HLA-DR(+), CD8(+) HLA-DR(+), CD8(+) CD38(+)), functional cell subsets (CD4(+) CD28(+)), and apoptotic cell subsets (CD4(+) CD95(+), CD8(+) CD95(+)). The plasma HIV loading was also detected. RESULTS: The CD4(+) cell count was (849 +/- 288) x 10(6)/L in the control group, significantly higher than that in HIV-infected person group (437 +/- 184) x 10(6)/L, P < 0.01], and that in AIDS patient group (50 +/- 51) x 10(6)/L, P < 0.01]. The CD8(+) cell count was (579 +/- 175) x 10(6)/L in the control group, significantly lower than that in HIV-infected person group (1 031 +/- 345) x 10(6)/L, P < 0.05], and not significantly different from that in AIDS patient group (535 +/- 338) x 10(6)/L, with a significant difference between the HIV-infected person group and AIDS patient group (P < 0.05). The percentage of CD4(+) CD45RA(+) CD62L(+) were 43.0% +/- 11.4% in the control group, not significantly different from that in HIV-infected person group (44.2% +/- 12.8%), but significantly higher than that in AIDS patient group (24.8% +/- 15.5%, P < 0.05). The CD4(+) CD45RA(+) CD62L(+) cell count was (368 +/- 162) x 10(6)/L in the control group, significantly higher than those in HIV-infected person group (185 +/- 134) x 10(6)/L] and in AIDS patient group (18 +/- 20) x 10(6)/L, both P < 0.01] with a significant difference between the HIV-infected person group and AIDS patient group (P < 0.01). The percentage of CD4(+) CD28(+) was 93.1% +/- 8.1% in the control group, significantly higher than those in HIV-infected person group (62.6% +/- 28.2%) and in AIDS patient group (56.9% +/- 26.4%) with a significant difference between any two groups (all P < 0.01). The percentages of CD4(+) HLA-DR(+), CD8(+) HLA-DR(+), and CD8(+) CD38(+) in the AIDS patient group were higher than those in the HIV-infected person group and control group with significant difference between any two groups (all P < 0.01). The percentages of CD4(+) CD95(+) and CD8(+) CD95(+) in the AIDS patient group were not significantly different from that in control group, but significantly higher than that in HIV-infected person group (P < 0.05). The plasma HIV loading was 3.74 +/- 0.78 lg copies/ml in the HIV-infected person group and was 4.94 +/- 0.68 lg copies/ml in AIDS patient group (P < 0.05), and the count of CD4(+) cells and CD4(+) CD45RA(+) CD62L(+) cells were obviously negatively correlated with the plasma HIV loading (r = -0.796, r = -0.750, P < 0.01). CONCLUSION: The T-lymphocyte immune dysfunction occurring in HIV-infected persons and AIDS patients in China involves not only the number, but also the function and activation of T-lymphocytes. Synthetical analysis of the alterations of different T cell subsets reflects the immune deficiency and severity of disease more comprehensively than pure examination of the amounts of CD4(+) and CD8(+) cells.