获得性免疫缺陷综合征患者胃黏膜组织人类免疫缺陷病毒感染分析

目的 探讨获得性免疫缺陷综合征(AIDS)患者胃黏膜组织中人类免疫缺陷病毒(HIV)感染的分布、数量及高效抗逆转录病毒治疗(HAART)前、后的变化.方法 选取伴有消化道症状的AIDS患者35例,对照组为HIV-1阴性者10例,均进行胃镜检查.PCR法制备地高辛标记HIV-1 LTR、gag基因的双链cDNA探针,对胃黏膜组织冰冻切片采取核酸原位杂交法观察HIV感染情况,并与外周血单个核细胞(PBMC)涂片对比.结果 ①AIDS患者胃镜下多表现为不同程度的慢性浅表性胃炎(CSG)和慢性萎缩性胃炎(CAG),AIDS患者临床消化道症状、胃镜下表现及病理结果未见明显特征性.②AIDS患者胃黏膜组织内HIV阳性显色多见于单个核细胞(MMC)中,胃黏膜上皮、腺上皮细胞和问质细胞中亦有阳性杂交信号.③胃窦黏膜组织与胃体黏膜组织HIV阳性率差异无统计学意义(P>0.05).④AIDS患者胃黏膜HIV阳性率为(1.97±3.25)%,AIDS未治疗组与HAART治疗组各组间胃窦和胃体部HIV阳性率差异均无统计学意义(P值均>0.05).PBMC中HIV总阳性细胞率为(12.38±9.17)%;AIDS未治疗组PBMC中HIV阳性细胞率为(19.37±9.23)%,AIDS治疗1～4年组为(4.25±3.47)%,两组间差异有统计学意义(P<0.05).结论 胃黏膜是HIV感染的靶部位之一,HAART治疗对AIDS患者胃黏膜感染收效甚微.

The analysis for human immunodeficiency virus infection in gastric mucosa from acquired immune deficiency syndrome patients

Objective To investigate the distribution and amount of human immunodeficiency virus (HIV) infection in gastric mucosa from untreated acquired immune deficiency syndrome (AIDS) patients and highly active antiretroviral therapy (HAART) treated patients.Methods Thirty-five AIDS patients (14 untreated patients and 21 patients receiving HAART) and 10 HIV-1 seronegative patients with gastrointestinal symptoms were enrolled and examined by upper endoscopy.The labeled HIV-1 double-stranded cDNA probe was a PCR product corresponding to the LTR and gag gene of the HIV-1 genome.HIV in gastric mucosal tissues from AIDS patients was detected using in situ hybridization (ISH) and compared with that in peripheral blood mononuclear cells (PBMC).Results ① No obvious character was found in gastrointestinal symptoms,endoscopy examination and pathology results of AIDS patients.② The expression of HIV gene was mainly detected in the gastric mucosal mononuclear cell (MMC).Other cells were also observed with HIV expression including mucosal epithelial cells,gland epithelial cells and interstitial cells.③There was no difference in HIV expression between sinus ventriculi and gastric body.④ HIV gene expression from AIDS patients was (1.97±3.25)% in gastric mucosa,no difference in HIV gene expression between two groups (P＞0.05).⑤ HIV gene expression in PBMC smear from AIDS patients was (12.38 ± 9.17)%.HIV expreesion in PBMC from patients who had received HAART for 1-4 years were markedly lower than that from patients who had not received HAART (P＜0.05).Conclusions The gastric mueosa is one of HIV infected sites.The potential effect of HAART on the decrease of HIV infected cells in gastric mucosa was unsatisfactory.