Rate of decline in CD4 count in HIV patients not on antiretroviral therapy

Background

The progressive decline in the CD4 count in HIV patients leads to a more general decline in immune functioning. The study has been carried out to determine the decline in CD4 count in HIV patients.

Methods

The study was conducted in a medical college hospital at Maharashtra. The information on baseline CD4 count was gathered from positive patient records registered in the central disease registry. The baseline CD4 count was the first count of CD4 obtained when the patient is diagnosed as HIV positive and further two subsequent readings. The time from baseline (t1) till the last CD4 count (t2) was divided into the different quartiles and the median decline in CD4 count in each quartile was determined. As the time between the two CD4 count measurements was not uniform the rate of change in CD4 was measured with respect to time as [X (t2) − X (t1)/(t2 − t1)]. Correlation was assessed using correlation coefficient.

Results

As the CD4 counts were following skewed distribution, the normality was achieved by cuberoot transformation. The overall rate of decline in CD4 count was estimated to be 35 cells/μL per year with 95% confidence interval (CI) as (17.01, 85.04). The correlation coefficient between decline in CD4 and the initial CD4 count in the four time quartiles was (r = −0.51; p = 0.001, r = −0.79; p = 0.000, r = −0.48; p = 0.015 and r = −0.80; p = 0.000) respectively. The median decline in the CD4 count in 0–6 months was 3 cells/μL, in (6–11) months was approximately 26 cells/μL, in (11–21.5) months was 30 cells/μL and in more than 21.5 months the median decline was 52 cells/μL.

Conclusions

There was a progressive decline in the CD4 count following HIV infection. An understanding of the influence of decline in CD4 count in HIV patients not on ART is important for clinical management of HIV disease.     

Engaging HIV-infected patients in antiretroviral therapy services: CD4 cell count testing after HIV diagnosis from 2005 to 2009 in Yunnan and Guangxi, China

Background  The initiation and expansion of China’s national free antiretroviral therapy program has led to significant improvement of survival among its participants. Success of further scaling up treatment coverage rests upon intensifying HIV screening and efficient linkage of care. Timely CD4 cell count testing after HIV diagnosis is necessary to determine whether a patient meets criteria for antiretroviral treatment, and represents a crucial link to engage HIV-infected patients in appropriate care, which has not been evaluated in China.

Methods  We evaluated all patients ≥16 years who tested HIV positive from 2005 to 2009 in Yunnan and Guangxi. Multivariate Logistic regression models were applied to identify factors associated with lack of CD4 cell count testing within 6 months after HIV diagnosis.

Results  A total of 83 556 patients were included. Over the study period, 30 635 (37%) of subjects received a CD4 cell count within 6 months of receiving the HIV diagnosis. The rate of CD4 cell count testing within 6 months of HIV diagnosis increased significantly from 7% in 2005 to 62% in 2009. Besides the earlier years of HIV diagnosis, negative predictors for CD4 cell count testing in multivariate analyses included older age, not married or unclear marriage status, incarceration, diagnosis at sexual transmitted disease clinics, mode of HIV transmission classified as men who have sex with men, intravenous drug users or transmission route unclear, while minority ethnicity, receipt of high school or higher education, diagnosis at voluntary counseling and testing clinics, and having HIV positive parents were protective.

Conclusions  Significant progress has been made in increasing CD4 testing among newly diagnosed HIV positive patients in Yunnan and Guangxi from 2005–2009. However, a sizable proportion of HIV positive patients still lack CD4 testing within 6 months of diagnosis. Improving CD4 testing, particularly among patients with identified risk factors, is essential to link patients with ART services and optimize treatment coverage.

     

抗病毒治疗对艾滋病感染者CD4+T淋巴细胞计数的影响

目的：探讨抗病毒治疗对艾滋病感染者CD4+T淋巴细胞计数的影响。方法选择2014年1月至2015年6月期间中山市疾病预防控制中心确诊的92例艾滋病患者,均接受高效抗逆转录病毒疗法(HAART)治疗,记录治疗前及治疗3个月、6个月时患者血CD4+T淋巴细胞计数的变化,分析影响CD4+T淋巴细胞计数增加量的相关因素。结果 HAART治疗3个月后,患者血CD4+T淋巴细胞计数出现上升者占88.04%;治疗6个月后,所有患者CD4+T淋巴细胞计数均有不同程度的上升,CD4+T淋巴细胞计数增加量在年龄<40岁、治疗前CD4+T淋巴细胞计数≥200、BMI≥23及无药物漏服的患者中明显高于年龄≥40岁、治疗前CD4+T淋巴细胞计数<200、BMI<23及有药物漏服者,差异均有统计学意义(P<0.05)。结论高效抗逆转录病毒疗法可显著增加艾滋病患者外周血CD4+T淋巴细胞计数,其疗效与年龄、治疗时机、BMI及用药依从性有关。     

Hepatitis B virus/human immunodeficiency virus coinfection: interaction among human immunodeficiency virus infection, chronic hepatitis B virus infection, and host immunity

Objective  This review discusses progress in the studies of hepatitis B virus (HBV)/human immunodeficiency virus (HIV) coinfection and focuses on the interaction among HIV infection, chronic HBV infection, and host immunity.

Data sources  Data and studies published mainly from 2008 to 2011 were selected using PubMed.

Study selection  Original articles and critical reviews concerning HBV/HIV coinfection and HBV and HIV pathogenesis were selected.

Results  HIV may accelerate HBV progression by lowering CD4 count, weakening HBV-specific immunity, “enriching” HBV mutants, causing immune activation, etc. On the other hand, HBV may enhance HIV replication by activating HIV long terminal repeat (LTR) with X protein (HBX) and cause immune activation in synergy with HIV. Paradoxically, HBV may also inhibit HIV dissemination via dendritic cells.

Conclusions  The interaction among HIV, HBV, and host immunity remains poorly understood. Further research is warranted to elucidate the detailed molecular mechanisms and to translate these mechanisms into clinical practice.

     

高效联合抗病毒治疗对艾滋病患者 CD4+T 淋巴细胞计数的影响

目的探讨高效联合抗病毒治疗对艾滋病患者外周静脉血CD4+T淋巴细胞计数的影响。方法收集2015年3月～2017年4月我市疾病预防控制中心确诊的150例艾滋病患者作为观察对象,均给予高效联合抗病毒疗法(HAART)治疗,记录治疗前及治疗后3个月、6个月、9个月、12个月时患者外周静脉血CD4~+T淋巴细胞计数变化情况,并分析影响患者外周静脉血CD4~+T淋巴细胞计数增加量的相关因素。结果 HAART治疗后,150例患者的外周静脉血CD4~+T淋巴细胞计数存在随着治疗时间延长而呈现增长的趋势,且治疗3、6、9及12个月时的CD4~+T淋巴细胞计数均明显高于治疗前,差异有统计学意义(P0.05)。性别以及治疗方案对患者外周静脉血CD4~+T淋巴细胞计数增加量无明显影响,差异无统计学意义(P0.05),年龄40岁、治疗前CD4~+T淋巴细胞计数≥200个/μL、BMI≥23 kg/m~2及无药物漏服者的CD4~+T淋巴细胞计数增加量均明显高于年龄≥40岁、治疗前CD4~+T淋巴细胞计数200个/μL、BMI23 kg/m~2及有药物漏服者,差异有统计学意义(P0.05)。结论高效联合抗病毒治疗有利于提高艾滋病患者外周静脉血CD4~+T淋巴细胞计数水平,且治疗效果与患者的年龄、BMI、治疗时机及服药依从性存在相关性。     

江苏省HIV感染者和艾滋病患者抗病毒治疗1年后CD4+T淋巴细胞检测结果分析

目的 :了解江苏省首次接受艾滋病免费抗病毒治疗的HIV/AIDS患者治疗1年后CD4+T变化及影响因素。方法 :收集江苏省首次接受抗病毒治疗的基线和治疗随访1年时均有CD4+T细胞检测结果记录的HIV/AIDS患者资料,随访截止时间为2014年5月31日。建立Excel数据库并用SPSS16.0软件进行分析。结果:首次接受抗病毒治疗的基线和随访1年时均有CD4+T检测结果记录的HIV/AIDS共3 290例。81.4%为江苏省籍,男女比例为4.36∶1,平均年龄(39.7±12.1)岁。感染途径主要为性传播。入组时基线CD4+T细胞计数均数为185.81个/μl。治疗1年后的CD4+T细胞均数为312.20个/μl。Logistic回归分析显示,年龄大、基线CD4+T高、在疾控中心治疗和临床Ⅰ期的HIV/AIDS患者,其CD4+T较基线增长值≥100个/μl的比例低。结论:江苏省HIV/AIDS抗病毒治疗对免疫功能恢复效果显著,应继续规范、早期开展抗病毒治疗工作。     

Impact of baseline CD4^＋ T cell counts on the efficacy of nevirapinebased highly active antiretroviral therapy in Chinese HIV/AIDS patients： a prospective,multicentric study

Background CD4^＋T cell counts have been used as the indicator of human immunodeficiency virus type 1 （HIV-1） disease progression and thereby to determine when to start highly active antiretroviral therapy （HAART）. Whether and how the baseline CD4^＋T cell count affects the immunological and viral responses or adverse reactions to nevirapine （NVP）-containing HAART in Chinese HIV-1 infected adults remain to be characterized. Methods One hundred and ninety-eight HIV-seropositive antiretroviral therapy （ART）-naive subjects were enrolled into a prospective study from 2005 to 2007. Data were analyzed by groups based on baseline CD4^＋T cell counts either between 100-200 cells/μl or 201-350 cells/μl. Viral responses, immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 52, 68, 84, 100. Results Eighty-six and 112 subjects ranged their CD4^＋T cell counts 100-200 cells/μl and 201-350 cells/μl, respectively. The pre-HAART viral load in CD4 201-350 cells/μl group was significantly lower than that in CD4 100-200 cells/μl group （P=0.000）. After treatment, no significant differences were observed between these two groups either in the plasma viral load （pVL） or in the viral response rate calculated as the percentage of pVL less than 50 copies/ml or less than 400 copies/ml. The CD4^＋T cell counts were statistically higher in the 201-350 group during the entire follow-ups （P 〈0.01） though CD4^＋ T cell count increases were similar in these two groups. After 100-week treatment, the median of CD4^＋ T cell counts were increased to 331 cells/μl for CD4 100-200 cells/μl group and to 462 cells/μl for CD4 201-350 cells/μl group. Only a slightly higher incidence of nausea was observed in CD4 201-350 cells/μl group （P=0.05） among all adverse reactions, including rash and liver function abnormality. Conclusions The pVLs and viral response rates are unlikely to be associated with the baseline CD4^＋T cell counts. Initiating HAART in Chinese HIV-1 infected patients with higher baseline CD4^＋T cell counts could result in higher total CD4^＋T cell counts thereby achieve a better immune recovery. These results support current guidelines to start HAART at a threshold of 350 cells/μl.     

重庆市1978例初始接受抗逆转录病毒治疗HIV感染者的回顾性分析

目的 了解重庆市人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者临床特征及影响疾病进展的危险因素.方法 收集2013-2015年在重庆市公共卫生医疗救治中心接受初始抗逆转录病毒治疗(antiretroviral therapy,ART)治疗的HIV感染者临床资料,根据病情对基本资料、临床检测指标、合并疾病进行回顾性分析.结果 1 978例初始接受ART治疗的HIV感染者中,54.9％的患者在ART治疗前病情进入艾滋病期,90％以上HIV感染者CD4+淋巴细胞水平低于350个/μL;病情进入艾滋病期的HIV感染者1个月内开始ART治疗的患者比例明显高于无症状期感染者(X2=69.14,P＜0.05),而HIV感染确证4个月后才开始ART治疗的无症状期感染者比例明显高于病情进入艾滋病期的感染者(X2 =75.56,P＜0.05);来自区县的患者中艾滋病期患者比例明显高于主城地区(X2 =28.50,P＜0.05),前者出现艾滋病的发病风险为后者的1.69倍(95％CI:1.47～1.95);接受ART治疗者以20 ～ 40岁的HIV感染者为主(58.6％),男男同性性行者在总病例中占有较高比例(47.6％),且病情进入艾滋病期者比例最低(39.6％),有男男同性性行为的HIV感染者进入艾滋病期的比例低于经其他途径获得感染者.结论 重庆市HIV感染者在诊断为HIV感染时,大部分已进入艾滋病期;无症状期HIV感染者存在拖延ART治疗开始时间的倾向;来自区县的HIV感染者艾滋病发病风险高于主城区感染者;年龄偏大和非经男男性行为途径而获得HIV感染的患者病情进展到艾滋病期的风险高于年轻和男男同性恋者.     

HIV viral load response to antiretroviral therapy according to the baseline CD4 cell count and viral load.

CONTEXT: It is unclear whether delay in initiation of antiretroviral therapy (ART) may lead to a poorer viral load response for patients with human immunodeficiency virus (HIV). OBJECTIVE: To characterize the relationship of viral load response to ART with baseline CD4 cell count and baseline viral load. DESIGN: Inception cohort of 3430 therapy-naive patients with HIV, of whom 3226 patients had at least 1 viral load count after the start of ART. SETTING: Three cohort studies of patients cared for in HIV clinics in Europe between 1996 and 2000. PATIENTS: All patients initiating ART consisting of at least 3 drugs initiated in or after 1996 and for whom CD4 cell count and viral load were available in the prior 6 months (at most). MAIN OUTCOME MEASURES: Viral load decrease to below 500 copies/mL; viral load rebound to above 500 copies/mL (2 consecutive values). RESULTS: Of 3226 patients during the median follow-up of 119 weeks, 2741 (85%) experienced viral suppression to less than 500 copies/mL by 32 weeks. Relative hazards (RHs) of achieving this were 1.08 (95% confidence interval [CI], 0.98-1.21) and 0.94 (95% CI, 0.84-1.04) for baseline CD4 cell counts between 200 and 349 x 10(6)/L and baseline CD4 cell counts lower than 200 x 10(6)/L, respectively, compared with baseline CD4 cell counts of 350 x 10(6)/L or higher, after adjustment for several factors including baseline viral load. For baseline viral load, the RHs were 0.95 (95% CI, 0.84-1.07) and 0.65 (95% CI, 0.58-0.74), for 10 000 to 99 999 and 100 000 copies/mL or greater, respectively, compared with less than 10 000 copies/mL, but the probability of viral load lower than 500 copies/mL at week 32 was similar in all 3 groups. Subsequent rebound above 500 copies/mL was no more likely with a lower baseline CD4 cell count or higher viral load. CONCLUSION: In this study, lower CD4 cell counts and higher viral loads at baseline were not associated with poorer virological outcome of ART. Those with baseline viral loads of greater than 100 000 copies/mL had a slower rate of achieving viral suppression.     

人细小病毒B19感染与孕晚期死胎的关系

目的：观察西安地区胎儿Ｂ１９感染状况及不明原因死胎与Ｂ１９感染的关系，探讨Ｂ１９感染后对胎儿的影响及危害程度，为优生优育提供预防措施。方法：用设计合成的两对引物和巢式聚合酶链反应方法扩增３０例石蜡包埋死胎肝脏组织Ｂ１９ＤＮＡ，阳性标本进一步排除ＴＯＲＣＨ感染。结果：检出Ｂ１９ＤＮＡ８例，其中２例合并ＴＯＲＣＨ感染。结论：西安地区胎儿存在Ｂ１９感染，但尚难说明和孕晚期死胎之间有相关性。     

HIV/AIDS患者皮肤黏膜表现与CD4+T淋巴细胞计数关系的临床分析

目的 通过分析HIV/AIDS患者皮肤黏膜表现的种类、严重程度及其与CD4 +T淋巴细胞计数的关系,评估皮肤黏膜病变预测、评价患者免疫状态的可行性. 方法 对345 例首诊确诊HIV/AIDS患者的临床资料进行回顾性研究,其中192例患者出现皮肤黏膜表现,153例无皮肤黏膜表现. 记录患者的CD4 +T淋巴细胞计数,观察HIV感染人群中各种皮肤病的发生率并分析皮肤病的种类、严重程度与患者免疫功能的相关性. 结果 HIV 阳性患者的皮肤病发生率为55.65%(192/345),皮肤黏膜损害的原因复杂,以真菌、病毒感染为主,分别为43.77%(151/345)、11.59%(40/345),其中以口腔念珠菌病发生率最高,达36.23%(125/345) ,其他包括马尔尼菲霉病、梅毒、单纯疱疹、颈部淋巴结核等都有较高的发生率. 无皮肤黏膜表现、出现1种和2种以上皮肤黏膜改变的CD4 +T淋巴细胞计数分别为(247 ±119)个/μl、(84 ±59)个/μl、(36 ±23)个/μl,差异均有统计学意义( P<0.05). 结论 HIV/AIDS患者皮肤黏膜表现多样,感染者免疫功能越差,越易并发皮肤黏膜疾病,某些皮肤黏膜表现可作为预测和评估HIV感染者免疫状态的临床指标.     

Correlation of CD4+ T cell count with total lymphocyte count, haemoglobin and erythrocyte sedimentation rate levels in human immunodeficiency virus type-1 disease

Background: Studies in human immunodeficiency virus (HIV) infected adults have demonstrated association of total lymphocyte count (TLC) <1200/mm³ and subseqnent disease progression or mortality. The association of other surrogate makers such as haemoglobin (Hb), and erythrocyte sedimentation rate (ESR) with CD4 count and disease progression has also been suggested. This study was carried out to determine the relationship of CD4-positive T lymphocyte counts with TLC, Hb and ESR in HIV-infected individuals.Methods: The study population comprised of 215 antiretroviral treatment naive HIV-1 infected adults. The CD4 positive T cell counts, TLC, Hb and ESR of study participants were measured. Spearman's rank order correlation and Receiver Operating Characteristic were used for statistical analyses.Result: The sensitivity, specificity, positive and negative likelihood ratios for cut-off value of TLC <1200/mm³ for predicting CD4 counts <200 cells/mm³ and <350 cells/mm³ were 9.4%, 100%, not measurable and 1.1, and 6.1 %, 98.8 %, 5.13 and 0.95, respectively. The association of Hb (<10, 11, 12 g/dl and <10, 12, 14 g/dl for CD4 counts <200 cells/mm³ and <350 cells/mm³, respectively), and ESR (<10, 20 and 30 mm fall after 1 hour) with these two CD4 counts cut-off values were suboptimal.Conclusion: This study reveals the poor association of TLC, Hb, and ESR with CD4 counts in HIV infected adults, thus highlighting the need to review the utility of these surrogate markers, for predicting CD4 counts in people living with HIV/AIDS.     

类风湿关节炎患者B19病毒感染及细胞因子变化

目的：了解国内类风湿关节炎（rheumatoid arthritis,RA)，幼年类风湿关节炎（juvenile rheumatoid arthritis,JRA)患人细小病毒B19（B19）的感染情况及其细胞因子（CK）IL－6，IL－8，sIL-2R和TNF－α水平的变化。方法：采用巢式PCR技术和丧心ELISA法对23例RA及30例JRA患血清（BS），4例JRA，6例骨性关节炎（OA）和9例半月板损伤（MT）关节液（SF）进行B19－DNA和IL－6，IL－8，sIL-2R,TNF-α等CK水平的检测。结果：（1）23例RA，30例JRA患BS B19－DNA均12例阳性，阳性率分别为52．1％和40．0％，与对照组比较差异显（P＜0．05）；（2＿4例JRA患SF中，3例B19－DNA阳性，6例OA和9例MT患均阴性；（3）23例RA，30例JRA患BS中，IL－6,SIL-2R水平与对照组相差非常显（P＜0．05）；（4）23例RA，30例JRA患B19－DNA阳性组与阴性组4种CK比较均无显差异（P＞0．05）；（5）SF标本中，4例JRA患的sIL-2R与其他两组有显差异（P＜0．01）。结果：（1）国内RA，JRA患有较高B19感染率，提示B19感染与RA，JRA密切相关；（2）IL－6 ,sIL-2R与RA，JRA活动性有关，是类风湿活动性的主要指标；（3）sIL-2R可能是参与JRA关节局部病理损伤最主要的CK之一；（4）BS中CK水平的变化与是否感染B19无关，即B19并非是导致RA，JRA的唯一因素。     

巢式PCR检测关节炎患者血清人细小病毒B19DNA

目的：探讨关节炎患者人细小病毒Ｂ１９（ＨＰＶＢ１９）的感染情况以及ＨＰＶＢ１９感染与类风湿性关节炎（ＲＡ）的相关性．方法：应用巢式ＰＣＲ方法对７４例单发或多发性关节炎患者以及对照组５０例非病毒感染相关性疾病、正常健康献血员及正常健康儿童血清进行ＨＰＶＢ１９－ＤＮＡ检测．结果：①病例组ＨＰＶＢ１９－ＤＮＡ阳性１５例（２０．３％）,其中６例为ＲＡ患者（４０％）,对照组阳性１例（２％）,相差非常显著（Ｐ     

HIV感染的CD4~+T淋巴细胞损伤机制

人类免疫缺陷病毒(HIV)感染引起机体免疫功能进行性受损,从而导致各种机会性感染和肿瘤。HIV对机体免疫系统的各个组成部分均可造成直接或间接的损伤,但CD4+T淋巴细胞是HIV攻击的     

CD4+ T Lymphocytes count in sickle cell anaemia patients attending a tertiary hospital

Background:

Sickle cell haemoglobin (HbS) is the commonest abnormal haemoglobin and it has a worldwide distribution. Reports have shown that patients with sickle cell anaemia (HbSS) have an increased susceptibility to infection leading to increased morbidity and mortality. Impaired leucocyte function and loss of both humoral and cell-mediated immunity are some of the mechanisms that have been reported to account for the immunocompromised state in patients with sickle cell disease. This study was carried out to determine the CD4+ T lymphocytes count in patients with sickle cell anaemia.

Materials and Methods:

A comparative cross-sectional study of 40 sickle cell anaemia patients in steady state (asymptomatic for at least 4 weeks) attending haematology clinic and 40 age and sex-matched healthy HbA control were recruited into the study. Both HbS patients and the controls were HIV negative. The blood samples obtained were analyzed for CD4+ T cell by Flow cytometry.

Results:

The study found that there was no significant difference in the number of CD4+ T lymphocyte count between individuals with sickle cell anaemia and HbA (1016 ± 513 cells/μL vs 920 ± 364cells/μL).

Conclusion:

It is recommended that the functionality of CD4+ T lymphocyte should be considered rather than the number in further attempt to elucidate the cellular immune dysfunction in patients with sickle cell anaemia.     

人微小病毒B19感染者血清生化改变的初步分析

目的研究感染人微小病毒 Ｂ１９（ＰＶＢ１９）的病毒性肝炎患者的血清生化改变情况。方法用巢式聚合酶链式反应法 检测病毒性肝炎患者和对照者的共 ４７３份血清中的 ＰＶＢ１９ ＤＮＡ,对 ＰＶＢ１９ ＤＮＡ阳性血清进行血清生化测定并对多 项生化指标进行多元统计分析。结果共检出 １７份 ＰＶＢ１９ ＤＮＡ阳性血清。 １７份血清中多项离子、肌酐、尿酸、葡萄糖、 乳酸脱氢酶等的水平正常,而尿素氮、胆红素、蛋白、肝脏酶的水平大多偏离正常值;经多元统计分析发现临床诊断为病 毒性肝炎的ＰＶＢ １９感染者与有其他症状的ＰＶＢ１９感染者在肝细胞受损程度及肝功能不全程度上有显著性差异。结 论感染ＰＶＢ１９不会引起离子水平、肾功能、糖代谢水平等的改变,但病毒性肝炎患者感染ＰＶＢ １９后血清生化改变与 其他患者不同,是否可用血清肝脏酶和胆红素水平的异常作为ＰＶＢ１９感染的辅助诊断还需进一步研究。     

巢式PCR检测胎儿组织人细小病毒B19感染

作用设计合成的两对引物建立了巢式ＰＣＲ－ＥＢ染色法检测Ｂ１９ＤＮＡ新技术，扩增产物为１０４ｂｐ片段，敏感性达０．００７ｆｇ，是一般ＰＣＲ的１００倍，是一种特异、敏感、简便、快速诊断Ｂ１９感染的新方法。用该方法检测了５７例自然流产和死胎的胎儿组织，１７例阳性，其中自然流产１１／４２（２６５），死胎６／１５（４０％），证实了国内胎儿有Ｂ１９病毒感染，和自然流产、死胎可能相关，并对ＰＣＲ实验中防污染措     

145例患儿血清中人类微小病毒B19-VP2-IgM的检测

目的 :探讨人类微小病毒B19(HumanParvovirusB19)在患儿中的感染情况。 方法 :用ELISA法对14 5例患儿 (大部分来自血液组 )和 4 8例健康儿童 (来自儿保体检门诊 ,对照组 )的血清标本进行了B19 VP2 IgM检测。 结果 :B19 VP2 IgM阳性检出率ITP和AA最高 ,分别为 4 4 .4 % (12 / 2 7)和 4 0 % (10 / 2 5 ) ,与对照相比差异有统计学意义 (P <0 .0 5 ) ,其它病组与对照组相比差异无统计学意义 (P >0 .0 5 )。 结论 :儿童对B19有较高的感染率 ,尤其ITP和AA患儿与B19感染关系更为密切。     

ART治疗对HIV感染者CD4+FoxP3+T细胞水平的影响

目的:探索抗逆转录病毒疗法(ART)治疗在HIV-1疾病进程中对调节性T细胞(Treg细胞)的影响,并探讨Treg细胞频率在HIV-1疾病进程中的作用.方法:抽取114例(男96例、女18例)HIV-1阳性患者及17例健康对照者外周血,应用流式细胞术检测Treg细胞,并分析其表达水平(频率和绝对数)在 HIV-1疾病进程中的变化趋势及其与CD4+细胞绝对数之间的相关性.结果:随着HIV-1感染者病情进展,患者外周血中Treg细胞绝对数趋向下降并且与CD4+T细胞绝对数呈正相关,而Treg细胞频率趋向升高并且与CD4+T细胞绝对数呈负相关.Treg细胞频率及绝对数在ART治疗无症状HIV-1阳性感染者中显著降低,而在AIDS患者中却显著升高.结论:Treg细胞参与艾滋病免疫发病过程,并且在HIV-1感染的不同阶段,ART治疗对Treg细胞水平具有一定的影响,提示通过控制Treg细胞的水平可能有助于HIV-1感染疾病的临床控制.