AIDS患者高效抗反转录病毒治疗后25-羟基维生素D水平与T细胞亚群含量及病毒载量的关系

李松鹏; 景红艳; 尹光凤; 雷黎明; 刘寿芳

文章摘要

AIDS患者高效抗反转录病毒治疗后25-羟基维生素D水平与T细胞亚群含量及病毒载量的关系

Relationship between 25 hydroxyvitamin D level and T cell subsets and viral load after highly active antiretroviral therapy in AIDS patients

DOI：10.3969/j.issn.1007-8134.2021.04.004

中文关键词: 艾滋病高效抗反转录病毒治疗 25-羟基维生素D T细胞亚群病毒载量

英文关键词: acquired immunodeficiency syndrome highly active antiretroviral therapy 25 hydroxyvitamin D T cell subsets viral load

基金项目:

作者	单位
李松鹏	昆明市第三人民医院检验科
景红艳	昆明市晋宁区人民医院检验科
尹光凤	昆明市第三人民医院检验科
雷黎明	昆明市第三人民医院检验科
刘寿芳	昆明市第三人民医院检验科

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中文摘要:

目的　探讨AIDS患者行高效抗反转录病毒治疗（highly active antiretroviral therapy, HAART）后25-羟基维生素D水平与T细胞亚群含量、病毒载量的关系。方法　选取2017年6月—2019年12月在本院诊治的128例AIDS患者，测定外周血中25-羟基维生素D、CD3+ T细胞、CD4+ T细胞、CD8+ T细胞以及HIV RNA水平，并分析相关性。结果　128例AIDS患者治疗后25-羟基维生素D、CD3+ T细胞、CD4+ T细胞水平及CD4/CD8比值均升高，CD8+ T细胞、HIV RNA水平降低，与治疗前相比差异均有统计学意义（P均＜0.05）。不同25-羟基维生素D水平的AIDS患者中，25-羟基维生素D≥30 ng/ml组CD3+ T细胞、CD4+ T细胞水平以及CD4/CD8比值升高，CD8+ T细胞、HIV RNA水平降低，与＜30 ng/ml组相比差异均有统计学意义（P均＜0.05）。不同 CD4+ T细胞水平的AIDS患者中，CD4+ T细胞≥500个/μl组25-羟基维生素D、CD3+ T细胞水平以及CD4/CD8比值升高，CD8+ T细胞、HIV RNA水平降低，与＜500个/μl组相比，差异均有统计学意义（P均＜0.05）。不同HIV RNA水平的AIDS患者中，HIV RNA＜400拷贝/ml组25-羟基维生素D、CD3+ T细胞、CD4+ T细胞水平以及CD4/CD8比值升高，CD8+ T细胞水平降低，与≥400拷贝/ml组相比差异均有统计学意义（P均＜0.05）。治疗后25-羟基维生素D水平与CD3+ T细胞（r=0.547，P=0.008）、CD4+ T细胞水平（r=0.821，P=0.000）及CD4/CD8比值（r=0.630，P=0.005）呈正相关，与CD8+ T细胞（r=-0.295，P=0.009）、HIV RNA水平（r=-0.460，P=0.001）呈负相关。治疗后HIV RNA水平与CD3+ T细胞（r=-0.702，P=0.004）、CD4+ T细胞水平（r=-0.681，P=0.006）及CD4/CD8比值（r=-0.729，P=0.007）呈负相关，与CD8+ T细胞水平呈正相关（r=0.392，P=0.008）。结论　AIDS患者行HAART后，25-羟基维生素D水平与CD3+ T细胞、CD4+ T细胞水平及CD4/CD8呈正相关，与CD8+ T细胞、HIV RNA水平呈负相关。

英文摘要:

Objective　To investigate the relationship between 25 hydroxyvitamin D level and T cell subsets and viral load after highly active antiretroviral therapy (HAART) in AIDS patients. Methods　A total of 128 AIDS patients who were diagnosed and treated in our hospital from June 2017 to December 2019 were selected. The levels of 25 hydroxyvitamin D, CD3+ T cell, CD4+ T cell, CD8+ T cell and HIV RNA in peripheral blood were determined, and the correlation was analyzed. Results　After therapy, the levels of 25 hydroxyvitamin D, CD3+ T cells, CD4+ T cells and the CD4/CD8 ratio were increased, while CD8+ T cells and HIV RNA levels were decreased in 128 AIDS patients, and the differences were statistically significant compared with those before treatment (P＜0.05). For AIDS patients with different 25 hydroxyvitamin D levels, the levels of CD3+ T cells and CD4+ T cells and the CD4/CD8 ratio increased, while CD8+ T cells and HIV RNA levels decreased in 25 hydroxyvitamin D≥30 ng/ml group. The differences were statistically significant compared with 25 hydroxyvitamin D ＜30 ng/ml group (P＜0.05). For AIDS patients with different CD4+ T cell levels, the levels of 25 hydroxyvitamin D, CD3+ T cells and CD4/CD8 ratio increased, while CD8+ T cells and HIV RNA levels decreased in CD4+ T cells ≥500 cells/μl group. The differences were statistically significant compared with CD4+ T cells ＜500 cells/μl group (P＜0.05). For AIDS patients with different HIV RNA levels, the levels of 25 hydroxyvitamin D, CD3+ T cells, CD4+ T cells and CD4/CD8 ratio increased, while CD8+ T cells decreased in HIV RNA＜400 copies/ml group. The differences were statistically significant compared with HIV RNA≥400 copies/ml group (P＜0.05). After therapy, the level of 25 hydroxyvitamin D was positively correlated with CD3+ T cells (r=0.547, P=0.008), CD4+ T cells (r=0.821, P=0.000), CD4/CD8 ratio (r=0.630, P=0.005), and negatively correlated with CD8+ T cells (r=-0.295, P=0.009) and HIV RNA levels (r=-0.460, P=0.001). After therapy, the level of HIV RNA was negatively correlated with CD3+ T cells (r=-0.702, P=0.004), CD4+ T cells (r=-0.681, P=0.006), CD4/CD8 ratio (r=-0.729, P=0.007), and positively correlated with CD8+ T cells (r=0.392, P=0.008). Conclusions　After HAART treatment, 25 hydroxyvitamin D level is positively correlated with CD3+ T cells, CD4+ T cells, CD4/CD8 ratio, and negatively correlated with CD8+ T cells and HIV RNA levels in AIDS patients.

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