Factors associated with collagen deposition in lymphoid tissue in long-term treated HIV-infected patients
Factors associated with collagen deposition in lymphoid tissue in long-term treated HIV-infected patients
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DOI：
10.1097/qad.0b013e32833c3268
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发表时间：
2010-08-24
期刊：
影响因子：
3.8
通讯作者：
Garcia, Felipe
中科院分区：
文献类型：
--
作者：
Diaz, Alba;Alos, Llucia;Garcia, Felipe
目的：探讨长期治疗的hiv感染者淋巴组织纤维化相关因素及其与免疫重建的相关性。方法：对7例首次接受抗逆转录病毒治疗的患者和29例治疗成功的患者（治疗中位时间为61个月）进行扁桃体活检。20例患者接受蛋白酶抑制剂保留方案和9例含蛋白酶抑制剂方案。5例hiv阴性个体扁桃体切除作为对照。评估淋巴组织结构、胶原沉积（纤维化）和平均滤泡间CD4（+）细胞计数每mm 2。结果：初治和长期治疗的hiv感染者的纤维化比例高于未感染hiv的患者（P < 0.001）。胶原沉积较多的患者淋巴组织CD4（+）细胞水平较低（P = 0.03），外周血CD4(+) T细胞水平升高较小（r = -0.40, P = 0.05）。与淋巴组织纤维化独立相关的因素是年龄（P < 0.0001），接受治疗的患者淋巴组织病毒载量可检测，与淋巴组织病毒载量不可检测的患者相比（中位数为5，分别为12%，P = 0.017），接受蛋白酶抑制剂保留方案与含有蛋白酶抑制剂方案的患者（中位数为8，分别为2.5%,P = 0.04）。结论：淋巴组织纤维化与CD4(+) T细胞重构不良有关，长期抗逆转录病毒治疗并不能逆转这种异常。在接受治疗的患者中，HIV感染、年龄较大、淋巴组织病毒载量可检测水平以及蛋白酶抑制剂保留方案似乎有利于淋巴组织纤维化。(C) 2010年Wolters Kluwer Health垂直条Lippincott Williams & Wilkins
Objective: The factors associated with fibrosis in lymphoid tissue in long-term treated HIV-infected patients and their correlation with immune reconstitution were assessed.Methods: Tonsillar biopsies were performed in seven antiretroviral-naive patients and 29 successfully treated patients (median time on treatment, 61 months). Twenty patients received protease inhibitors-sparing regimens and nine protease inhibitor-containing regimens. Five tonsillar resections of HIV-negative individuals were used as controls. Lymphoid tissue architecture, collagen deposition (fibrosis) and the mean interfollicular CD4(+) cell count per mm 2 were assessed.Results: Naive and long-term treated HIV-infected patients had a higher proportion of fibrosis than did HIV-uninfected persons (P < 0.001). Patients with greater collagen deposition showed lower levels of CD4(+) cells in lymphoid tissue (P = 0.03) and smaller increase in peripheral CD4(+) T cells (r = -0.40, P = 0.05). The factors independently associated with fibrosis in lymphoid tissue were age (P < 0.0001), treated patients with detectable lymphoid tissue viral load when compared with patients with undetectable lymphoid tissue viral load (median 5 vs. 12%, respectively, P = 0.017) and patients receiving a protease inhibitor-sparing vs. a protease inhibitor-containing regimen (median 8 vs. 2.5%, respectively, P = 0.04).Conclusion: Fibrosis in lymphoid tissue was associated with a poor reconstitution of CD4(+) T cells and long-term antiretroviral therapy did not reverse this abnormality. HIV infection, older age, a detectable level of lymphoid tissue viral load in treated patients and protease inhibitor-sparing regimens seem to favour fibrosis in lymphoid tissue. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins