中国HIV感染者IL-2和IL-7参与高效抗反转录病毒治疗的抗病毒免疫反应及其在病毒控制中的作用

目的观察中国HIV-1感染者在高效抗反转录病毒治疗（Highly active antiretroviral therapy，HAART）中，外周血HIV-1RNA、CD4＋T淋巴细胞数量和IL-2、IL-7的相关关系，探讨这些^y链细胞因子与抗HIV病毒免疫应答及其在病毒控制中的作用。方法2009年6月至2010年12月，35椤iI接受初次HAART的慢性HIV-1感染者被纳入本研究并随访48周，检测HAART治疗0、24、48周时的外周血HIV．1RNA定量、CD4＋T淋巴细胞数、IL-2以及IL-7水平，并分析其相关性。结果35例HIV．AIDS在HAART治疗前的IL-2水平[（9．67±2．6）pg／ml]明显低于正常对照值[（27．36±5．05）pg／ml]，在经过48周治疗后显著升高[（19．8±3．3）pg／ml]，而在HAART治疗前的IL-7水平[（81．74±20．47）pg／ml]明显高于正常对照值[（2．06±1．52）pg／ml]，在48周治疗后则显著降低[（8．36±2．16）pg／ml]。IL-2水平在HAART的0、48周与CD4＋细胞计数呈相同变化趋势但相关性不明显（O周：R=0．21，P=0．063；48周：R=0．19，P=0．103），24周呈正相关（R=0．24，P=0．033），而IL-7水平在HAART的0周与CD4＋细胞计数呈负相关（R=-0．28，P=0．012），在24、48周无相关。IL-2水平和HIVRNA病毒载量呈负相关（R=-0．17，P=0．032），而IL-7水平和HIV RNA病毒载量关系不明显（P=0．76）。结论48周HAART治疗中IL-2和IL-7水平均有明显变化。与CD4＋T细胞计数变化密切相关，与外周血HIV RNA水平有一定关系。提示这些细胞因子在免疫重建和病毒控制中起重要作用。

Dynamics of IL-2 and IL-7 levels during Highly active antiretroviral therapy and their significance

Objective The objective of this study was to investigate the course of certain common gamma cytokines （ IL-2 and IL-7） and their role on the control of the viral infection in a short term antiviral therapy. Methods A total of 35 adults with chronic HIV infection, responding to combined antiretroviral therapy （cART） gnidehne criteria were enrolled in this one year follow-up study. After signing an informed consent, 20 ml blood were collected from each patient at base line, week 0, week 24 and week 48. 1 ml serum collected from each patient was kept at -80 ＊ C until use. Serum concentration of IL-2 and IL-7 was determined using ELISA kit from ＂ebioscience Beijing＂. CIM and CD8 cells were counted and quantified u- sing flux cytometry, and serum HIV RNA was quantified using real time PCR. Results All patients had a mean baseline IL-2 level [ （9. 67 ± 2. 6） pg/ml ] lower than the controls [ （ 27. 36 ± 5.05 ） pg/ml ]. After treatment for 48 weeks, IL-2 increased[ （19. 8 ±3.3）pg/ml]. However, the mean baseline IL-7 [ （81.74 ±20. 47） pg/ml] in patients was higher than controls [ （ 2. 06 ± 1.52） pg/ml]. After treatment for 48 weeks, IL-7 decreased [ （8.36 ± 2. 16） pg/ml ]. IL-2 showed a significant increase and positive correlation with CD4 cells after HAART initiation （0week：R =0. 21, P =0. 063.24week：R =0. 24. P =0. 033.48week：R = 0. 19, P = 0. 103 ; IL-7 showed a significant decrease after HAART initiation but it did not show correlation with CIM cells. We noted there was a negative correlation between IL-2 and CD4 count in HAART baseline （R = 0. 28, P = 0. 012）, but no correlation between IL-7 and CD4 count from 6 month after HAART. IL-2 showed negative correlation with HIV RNA （ R = - 0. 17, P = 0. 032）, but IL-7 showed a relationship with the HIV RNA. Conclusions The increase of IL-2 coupled with the decrease of IL-7 re= vealed a partial restoration of immune response during HAART. However, the absence of relationship with HIV RNA suggested that these cytokines might not be directly involved in the reduction of viral load.