摘要目的 观察中国HIV-1感染者在高效抗反转录病毒治疗(Highly active antiretroviral therapy,HAART)中,外周血HIV-1 RNA、CD4 +T淋巴细胞数量和IL-2、IL-7的相关关系,探讨这些γ链细胞因子与抗HIV病毒免疫应答及其在病毒控制中的作用.方法 2009年6月至2010年12月,35例接受初次HAART的慢性HIV-1感染者被纳入本研究并随访48周,检测HAART治疗0、24、48周时的外周血HIV-1 RNA定量、CD4 +T淋巴细胞数、IL-2以及IL-7水平,并分析其相关性.结果 35例HIV-AIDS在HAART治疗前的IL-2水平[(9.67±2.6)pg/ml]明显低于正常对照值[(27.36±5.05)pg/ml],在经过48周治疗后显著升高[(19.8±3.3) pg/ml],而在HAART治疗前的IL-7水平[ (81.74 ±20.47) pg/ml]明显高于正常对照值[(2.06±1.52)pg/m1],在48周治疗后则显著降低[(8.36±2.16) pg/ml].IL-2水平在HAART的0、48周与CD4+细胞计数呈相同变化趋势但相关性不明显(0周:R=0.21,P=0.063；48周:R=0.19,P=0.103),24周呈正相关(R=0.24,P=0.033),而IL-7水平在HAART的0周与CD4+细胞计数呈负相关(R=-0.28,P=0.012),在24、48周无相关.IL-2水平和HIV RNA病毒载量呈负相关(R=-0.17,P=0.032),而IL-7水平和HIV RNA病毒载量关系不明显(P=0.76).结论 48周HAART治疗中IL-2和IL-7水平均有明显变化.与CD4 +T细胞计数变化密切相关,与外周血HIV RNA水平有一定关系.提示这些细胞因子在免疫重建和病毒控制中起重要作用.

abstractsObjective The objective of this study was to investigate the course of certain common gamma cytokines ( IL-2 and IL-7 ) and their role on the control of the viral infection in a short term antiviral therapy.Methods A total of 35 adults with chronic HIV infection,responding to combined antiretroviral therapy (cART) guideline criteria were enrolled in this one year follow-up study.After signing an informed consent,20 ml blood were collected from each patient at base line,week 0,week 24 and week 48.1 ml serum collected from each patient was kept at -80 * C until use.Serum concentration of IL-2 and IL-7 was determined using ELISA kit from "ebioscience Beijing".CD4 and CD8 cells were counted and quantified using flux cytometry,and serum HIV RNA was quantified using real time PCR.Results All patients had a mean baseline IL-2 level [ (9.67 ± 2.6 ) pg/ml ]lower than the controls [ ( 27.36 ± 5.05 ) pg/ml ].After treatment for 48 weeks,IL-2 increased[ ( 19.8 ± 3.3 ) pg/ml ].However,the mean baseline 1L-7 [ ( 81.74± 20.47 ) pg/ml ]in patients was higher than controls [ ( 2.06 ± 1.52 ) pg/ml ].After treatment for 48 weeks,IL-7 decreased [ (8.36 ± 2.16)pg/ml ].IL-2 showed a significant increase and positive correlation with CD4 cells after HAART initiation (0week:R =0.21,P =0.063,24week:R =0.24,P =0.033,48week:R =0.19,P =0.103; IL-7 showed a significant decrease after HAART initiation but it did not show correlation with CD4 cells.We noted there was a negative correlation between IL-2 and CD4 count in HAART baseline (R =0.28,P =0.012 ),but no correlation between IL-7 and CD4 count from 6 month after HAART.IL-2 showed negative correlation with HIV RNA ( R =- 0.17,P =0.032),but IL-7 showed a relationship with the HIV RNA Conclusions The increase of IL-2 coupled with the decrease of IL-7 revealed a partial restoration of immune response during HAART.However,the absence of relationship with HIV RNA suggested that these cytokines might not be directly involved in the reduction of viral load.