外周血HIV-1 DNA在艾滋病療效評(píng)估中的應(yīng)用

方星　張信輝　劉水青　鄭燕　楊興林　付琳　柳興鳳

[關(guān)鍵詞] 人類免疫缺陷病毒;抗逆轉(zhuǎn)錄病毒治療;HIV-1 DNA;HIV-1 RNA;CD4+T淋巴細(xì)胞

[中圖分類號(hào)] R512.9? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2021）22-0152-04

Application of peripheral blood HIV-1 DNA in the evaluation of AIDS efficacy

FANG Xing1? ?ZHANG Xinhui1? ?LIU Shuiqing2? ?ZHENG Yan2? ?YANG Xinglin2? ?FU Lin1? ?LIU Xingfeng3

1.Guizhou Provincial Center for Disease Control and Prevention/Experimental Center， Guiyang? ?550000， China; 2. Guiyang Public Health Rescue Center， Guiyang? ?550000， China; 3.Zunyi Medical University/Key Laboratory of Brain Science Characteristics of of Guizhou Colleges and Universities， Zunyi? ?563000， China

[Abstract] Objective To study the relationship between HIV-1 DNA and HIV-1 RNA and CD4+T lymphocytes of HIV-infected persons， and to explore the application of peripheral blood HIV-1 DNA in the efficacy evaluation of AIDS. Methods A total of 80 HIV-infected patients in the Guiyang Public Health Rescue Center from June to September 2018 were selected. Face-to-face questionnaire surveys were used to collect patient data， and K2EDTA anticoagulant blood was collected from patients. The CD4+ T lymphocytes， HIV-1 The RNA and HIV-1 DNA were tested， and the results were obtained. The virus pool level of HIV-infected persons， the correlation between HIV-1 DNA and HIV clinical stage， CD4+T lymphocyte count and HIV-1 RNA were analyzed through SPSS. Results The higher the number of CD4+T lymphocytes in HIV-infected persons， the lower the HIV-1 RNA content and the lower the HIV-1 DNA level in their whole blood. The differences were statistically significant（P<0.05）. Conclusion HIV-1 DNA can reflect the level of virus pool during antiretroviral therapy（HAART）， suggest disease progression， and evaluate the effect of treatment. It can provide a more accurate monitoring method for AIDS treatment in Guizhou Province.

[Key words] Human immunodeficiency virus; Antiretroviral therapy; HIV-1 DNA; HIV-1 RNA; CD4+ T lymphocytes

高效聯(lián)合抗逆轉(zhuǎn)錄病毒治療（Highly active anti-retroviral therapy，HAART）通過(guò)有效抑制HIV復(fù)制，降低人體內(nèi)病毒載量，重建患者免疫功能，顯著降低了HIV相關(guān)疾病的發(fā)生率和病死率[1-2]。目前，艾滋病抗病毒治療已證實(shí)是最有效的治療手段[3]，一旦停藥，多數(shù)患者2周左右便會(huì)出現(xiàn)外周血病毒反彈，使得HIV患者需要終身堅(jiān)持HAART治療，且存在著藥物毒副作用、耐藥、依從性差及沉重的經(jīng)濟(jì)負(fù)擔(dān)等問(wèn)題。有研究顯示，在 HIV 感染早期 HIV-1 DNA就已經(jīng)整合到感染細(xì)胞中并持續(xù)存在，形成病毒儲(chǔ)存庫(kù)（Reservoir），而被整合的感染細(xì)胞處于靜息狀態(tài)，不表達(dá)病毒蛋白，不被體內(nèi)免疫細(xì)胞識(shí)別，亦不受抗病毒治療的影響，可在感染者體內(nèi)長(zhǎng)期存在，因此雖然通過(guò)HAART能夠有效降低血漿艾滋病病毒載量，但因 HIV-1 DNA 的持續(xù)存在不能徹底清除體內(nèi)的病毒，從而造成HIV感染難以治愈[4-7]。目前，HIV病毒儲(chǔ)存庫(kù)造成艾滋病病毒的反彈已被廣泛認(rèn)同是HAART無(wú)法徹底清除HIV和治愈艾滋病的主要原因[8]。控制HIV病毒儲(chǔ)存庫(kù)可能成為艾滋病功能性治愈的新策略[9-11]。根據(jù)已成熟的方法[12]，本研究旨在通過(guò)研究HIV感染者HIV-1 DNA與HIV-1 RNA及CD4+T淋巴細(xì)胞間的關(guān)系，探討外周血HIV-1 DNA在艾滋病療效評(píng)估中的應(yīng)用。為實(shí)現(xiàn)貴州省的“三個(gè)90%”和艾滋病的治療提供更精準(zhǔn)的監(jiān)測(cè)手段，現(xiàn)報(bào)道如下。