中国部分地区HIV感染者/艾滋病患者外周血单核/巨噬细胞功能与疾病的进展关系

目的 通过对中国HIV感染者／艾滋病（AIDS）患者外周血单核／巨噬细胞标志抗原CD14及其早期活化分子CD69的研究,探讨其外周血单核／巨噬细胞的功能状态与HIV感染者疾病进程的关系。方法采集57例未经抗病毒治疗的HIV感染者／AIDS患者及32例健康人抗凝全血,运用流式细胞分析技术对CD4^＋T淋巴细胞、CD14^＋细胞及其CD69抗原表达情况进行测定,并采用实时荧光定量RT-PCR技术检测患者血浆HIV-1载量。结果（1）HIV感染者／AIDS患者外周血CD14^＋细胞颗粒度SSC值为76±16,CD69分子在CD14^＋细胞的表达率为27％±4％,均明显高于对照组（P〈0．05）,其中AIDS组高于HIV慢性感染（HIV）组及长期不进展（LTNP）组,HIV组高于LTNP组（P〈0．05）,LTNP组与对照组比较差异无统计学意义;外周血CD14^＋细胞比例、CD14抗原水平与对照组相比差异无统计学意义。（2）HIV感染者／AIDS患者外周血CD69分子在CD14^＋细胞的表达率与CD4^＋T淋巴细胞绝对值呈明显负相关（r=-0．872,P〈0．01）,与HIV-1RNA病毒载量呈显著正相关（r=0．697,P〈0．01）。结论中国部分地区HIV／AIDS患者外周血单核／巨噬细胞的活化和吞噬功能较健康对照组有显著上升,且与疾病进展密切相关。

Correlation between the function of monocytes/macrophages and disease progression in people living with HIV/AIDS in several provinces in China

OBJECTIVE: To investigate the functional states of peripheral blood monocytes/macrophages and their relation with the disease progression in people living with HIV/AIDS (PWHA). METHODS: Peripheral blood samples were collected from 57 PWHA who didn't receive antivirus treatment before and 32 healthy controls in Jilin, Liaoning, and Henan provinces. Flow cytometry was used to detect the expression of the early activation molecule CD69 in the CD14(+) cells. The plasma HIV RNA level was determined using real-time PCR. RESULTS: The CD69 expression rate in the CD14(+) T cells of the PWHA group was 27% +/- 4%, significantly higher than that of the controls (P < 0.01). The CD69 expression rate of the AIDS group was 39% +/- 3%, significantly higher than those of the HIV group and long-term nonprogressors (LTNP) group (26% +/- 3% and 20% +/- 4% respectively, both P < 0.05), that of the HIV groups being significantly higher than that of the LTNP group too (P < 0.05). The side scatter value of the CD14(+) T cells of the PWHA group was 76 +/- 16, significantly higher than that of the control group (50 +/- 12, P < 0.05). The monocyte/macrophage CD69 expression rate was significantly negatively correlated with the absolute value of CD4(+) T cells (r = -0.872, P < 0.01), and not correlated with the value of CD8(+) T cells (P > 0.05). The monocyte/macrophage CD69 expression rate was significantly positively correlated with the HIV-1 RNA viral load (r = 0.697, P < 0.01). CONCLUSION: The activation and the phagocytosis function of the monocytes/macrophages of the PWHA in China are higher than those of the healthy control. They are positively correlated with the disease progression.