摘要目的:了解高效抗逆转录病毒治疗(highly active antiretroviral therapy，HAART)后HIV/AIDS患者T淋巴细胞免疫活化及CD4 ＋CD45RA ＋ T细胞的亚群变化，探讨抗病毒治疗对HIV感染者免疫恢复的影响。 方法:前瞻性分析105例接受HARRT治疗的HIV/AIDS患者，流式细胞仪检测治疗前和治疗后1、3、6及12个月T淋巴细胞活化水平(CD38、HLA-DR的表达)及CD4 ＋CD45RA ＋ T淋巴细胞；同时选取未暴露且HIV-1抗体检测阴性者35名作为健康对照。 结果:HAART治疗前HIV/AIDS患者T淋巴细胞活化水平显著高于健康对照( P<0.01)，HAART治疗后随治疗时间延长活化水平明显下降，治疗1个月时CD4 ＋CD38 ＋ HLA-DR ＋及CD8 ＋CD38 ＋ 、CD8 ＋ HLA-DR ＋ T淋巴细胞首先出现降低，治疗6个月时包含CD8 ＋CD38 ＋HLA-DR ＋ T在内的4项活化指标均明显下降，差异有统计学意义( P<0.01)；治疗12个月与6个月相比，CD8 ＋CD38 ＋HLA-DR ＋ T表达水平继续降低( P<0.01)，而其余3项活化指标差异无统计学意义。但HAART治疗12个月后，4项活化指标仍全部高于健康对照组( P<0.01)。CD4 ＋CD45RA ＋ T淋巴细胞百分比在治疗前及治疗后12个月均明显低于健康对照组。 结论:HIV/AIDS患者在HAART治疗后6个月免疫活化水平降低，但HAART并不能使免疫活化逆转；HAART治疗也不能恢复HIV感染后降低的CD4 ＋CD45RA ＋ T淋巴细胞的水平。

abstractsObjective:To investigate the effects of highly active anti-retroviral therapy (HAART) on the activation of T lymphocytes and expression of CD4 + CD45RA + T cell subsets in HIV/AIDS patients. Methods:This study prospectively analyzed 105 HIV/AIDS patients undergoing HAART and 35 HIV-1-negative cases (healthy controls). Flow cytometry was used to detect the activation of T lymphocytes and the percentages of CD4 + CD45RA + T cell subsets in whole blood samples taken from healthy controls and HIV/AIDS patients before and after therapy. Results:The activation of T lymphocytes was significantly enhanced in the 105 HIV/AIDS patients than in the healthy controls before treatment ( P<0.01). The activated T lymphocytes gradually decreased after HAART. Firstly, CD4 + CD38 + HLA-DR + , CD8 + CD38 + and CD8 + HLA-DR + T lymphocytes decreased one month after therapy ( P<0.05). Then, four indicators of T lymphocyte activation including the expression of CD8 + CD38 + HLA-DR + T lymphocytes decreased significantly six months after therapy ( P<0.01). The percentage of CD8 + CD38 + HLA-DR + T lymphocytes detected 12 months after therapy was significantly lower than that analyzed six months after therapy ( P<0.01). No significant difference was found in the expression of the other three indicators for activation ( P>0.05). Twelve months after therapy, the four indicators for T lymphocyte activation in HIV/AIDS patients were still significantly higher than those of the control group ( P<0.01). The percentages of CD4 + CD45RA + T lymphocytes in HIV/AIDS patients were significantly lower than those in healthy controls before and 12 months after treatment ( P>0.05). Conclusions:HAART could reduce immune activation after six months of treatment, but could not reverse the activation nor restore the expression of CD4 + CD45RA + T lymphocytes in HIV/AIDS patients.