方星　张信辉　刘水青　郑燕　杨兴林　付琳　柳兴凤

[关键词] 人类免疫缺陷病毒;抗逆转录病毒治疗;HIV-1 DNA;HIV-1 RNA;CD4+T淋巴细胞

[中图分类号] R512.9          [文献标识码] B          [文章编号] 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

高效聯合抗逆转录病毒治疗（Highly active anti-retroviral therapy，HAART）通过有效抑制HIV复制，降低人体内病毒载量，重建患者免疫功能，显著降低了HIV相关疾病的发生率和病死率[1-2]。目前，艾滋病抗病毒治疗已证实是最有效的治疗手段[3]，一旦停药，多数患者2周左右便会出现外周血病毒反弹，使得HIV患者需要终身坚持HAART治疗，且存在着药物毒副作用、耐药、依从性差及沉重的经济负担等问题。有研究显示，在 HIV 感染早期 HIV-1 DNA就已经整合到感染细胞中并持续存在，形成病毒储存库（Reservoir），而被整合的感染细胞处于静息状态，不表达病毒蛋白，不被体内免疫细胞识别，亦不受抗病毒治疗的影响，可在感染者体内长期存在，因此虽然通过HAART能够有效降低血浆艾滋病病毒载量，但因 HIV-1 DNA 的持续存在不能彻底清除体内的病毒，从而造成HIV感染难以治愈[4-7]。目前，HIV病毒储存库造成艾滋病病毒的反弹已被广泛认同是HAART无法彻底清除HIV和治愈艾滋病的主要原因[8]。控制HIV病毒储存库可能成为艾滋病功能性治愈的新策略[9-11]。根据已成熟的方法[12]，本研究旨在通过研究HIV感染者HIV-1 DNA与HIV-1 RNA及CD4+T淋巴细胞间的关系，探讨外周血HIV-1 DNA在艾滋病疗效评估中的应用。为实现贵州省的“三个90%”和艾滋病的治疗提供更精准的监测手段，现报道如下。