HIV／AIDS患者血浆病毒载量及外周血T淋巴细胞亚群的变化

目的：观察国内HIV／AIDS患者血浆病毒载量和外周血CD4^ 、CD8^ T淋巴细胞的变化，探讨这些变化的临床意义。方法：选择未经抗病毒治疗的HIV／AIDS患者124例，用bDNA法检测血浆病毒载量，并用流式细胞仪检测外周血CD4^ 、CD8^ T淋巴细胞。结果：AIDS患者的血浆病毒载量明显高于HIV感染者，血浆病毒载量与CD4^ 细胞计数呈显著负相关，但其最高峰位于CD4^ 细胞计数100／μl处，然后随着CD4^ 细胞计数的下降而减少。CD4^ T细胞计数为AIDS组＜HIV组＜正常对照组：HIV感染者的CD8^ T细胞计数显著高于正常组和AIDS组，而AIDS患者CD8^ T细胞数则随着CD4^ T细胞减少而下降。结论：血浆病毒载量随着疾病进展而显著升高，但在疾病晚期则有所降低。外周血CD4^ T细胞计数随着疾病的进展而进行性减少；CD8^ T细胞计数在感染早期显著升高，进入晚期则减少。在评价HIV感染者和AIDS患者病情时，应结合病毒载量、CD4^ 、CD8^ T细胞计数综合分析。

Changes of plasma viral load and peripheral T lymphocyte subsets in HIV/AIDS patients

Objective To investigate the changes in plasma viral load and CD4+ and CD8+ T lymphocyte counts in HIV/AIDS patients and explore their clinical significance. Methods A total of 124 HIV/AIDS patients who had not been treated with HAART were included in this study. Of the 124 patients, 68 were asymptomatic HIV - infected individuals and 56 AIDS patients. The plasma viral load was measured in all the patients. Meanwhile, peripheral blood CD4+ and CD8+ T lymphocyte counts were determined by flow cytometry in all the patients and 51 healthy blood donors. Results The viral load was higher in AIDS patients than in HIV- infected individuals. There was negative correlation between plasma viral load and CD4+ t cell counts ( r = 0.607, P = 0. 001). The peak value of plasma viral load was found at the CD4 + cell count level of 100/ul and then it decreased along with the decline of CD4+ T cell count. The counts and percentage of CD4+ T cells were increased in order from AIDS patients, HIV -infected individuals to healthy blood donors. CD8+ t cell lymphocyte count was higher in HIV- infected individuals than in AIDS patients and healthy blood donors. Furthermore, CD8+ T lymphocyte count in AIDS patients declined following CD4 + T cell decrease. Conclusions Plasma viral load increases along with disease progression but decreases in late stage. The count of CD4 + T lymphocytes decreases a-long with disease progression. CD4+ T lymphocyte count increases in the early stage then declines following CD4+ T cell count decline in the late stage. Plasma viral load and CD4+ and CD8+ T lymphocyte counts should be analyzed together in evaluation of HIV infection condition.