病毒学抑制的HIV - 1感染者免疫衰老相关CD4+T淋巴细胞亚群的分析

目的 了解病毒学抑制的HIV - 1感染者CD4+ T淋巴细胞免疫衰老状态，探索主成分分析法能否用于评价HIV - 1患者的免疫衰老。方法 选择抗逆转录疗法治疗半年以上成年病毒学抑制HIV - 1感染者，根据CD4+T淋巴细胞计数结果分为CD4无缺陷组（≥500个/μl）和缺陷组（＜500个/μl），每组65人，另选择22名未暴露且HIV - 1抗体检测阴性者作为对照组，采用流式细胞仪检测其CD4+T淋巴细胞（CD45RA+CD27+）、活化CD4+T淋巴细胞（HLA - DR+CD38+）和复制性衰老CD4+T淋巴细胞（CD57+CD28-）水平，运用主成分分析对三种细胞进行综合分析。结果 缺陷组（27.64%）和无缺陷组（32.04%）的初始CD4+T淋巴细胞较对照组（51.27%）有明显下降（F = 24.35，P＜0.001），活化CD4+T淋巴细胞（14.26%，13.03%）较对照组（2.35%）有明显上升（F = 19.75，P＜0.001）；缺陷组（12.64%）的复制性衰老CD4+T淋巴细胞较无缺陷组（7.36%）和对照组（3.58%）有明显升高（F = 6.68，P = 0.002），而无缺陷组和对照组之间无统计学差异；主成分分析能区分出三组对象CD4+T淋巴细胞免疫衰老的差异程度:缺陷组＞无缺陷组＞对照组（F = 20.787，P＜0.001）。结论 病毒学抑制良好的HIV - 1感染者即使CD4+T细胞数量正常也表现为免疫衰老，CD4+T细胞数量异常的人免疫衰老状态更严重，可运用主成分分析对病毒学抑制的HIV - 1感染者免疫衰老相关细胞进行综合分析。

Analysis of CD4+T cell subsets of immunosenescence in virologically suppressed HIV-1 infected persons

Objective To understand the differences in the expression of immunosenescence-related cells in virologically suppressed HIV-1 infected persons, and to explore whether the comprehensive evaluation method can be used to evaluate the immunosenescence of HIV-1 patient. Methods Adult virologically suppressed HIV-1-infected patients treated with antiretroviral therapy for more than six months were selected and divided into CD4-free (≥500/μL) and defective (<500/μL) groups based on CD4+T lymphocyte count results, with 65 individuals in each group, and 22 unexposed and HIV-1 antibody-test-negative individuals were selected as the control group, and their CD4+T lymphocytes (CD45RA+CD27+), activated CD4+T lymphocytes (HLA-DR+CD38+) and replicative senescent CD4+T lymphocytes (CD57+CD28-) levels by flow cytometry, and the three cell types were analyzed together using principal component analysis. Results There was a significant decrease in initial CD4+T lymphocytes (F=24.35, P<0.001) and a significant increase in activated CD4+T lymphocytes (14.26%, 13.03%) in the defective (27.64%) and nondefective groups (32.04%) compared to the control group (51.27%) (F=19.75, P<0.001); replicative senescent CD4+T lymphocytes were significantly higher (F=6.68, P=0.002) in the defective group (12.64%) compared to the nondefective group (7.36%) and the control group (3.58%), while there was no statistical difference between the nondefective and control groups; principal component analysis was able to distinguish the degree of difference in immunosenescence of CD4+ T lymphocytes among the three groups of subjects: defective group > non-defective group > control group (F=20.787, P<0.001). Conclusion HIV-1-infected individuals with good virological suppression exhibit immune senescence even with normal CD4+T cell counts, and those with abnormal CD4+T cell counts have a more severe state of immune senescence, and a comprehensive analysis of cells associated with immune senescence in virologically suppressed HIV-1-infected individuals can be performed using principal component analysis.