CHANGES IN LYMPHOCYTE-T SUBSETS IN INTRAVENOUS-DRUG-USERS WITH HIV-1 INFECTION
CHANGES IN LYMPHOCYTE-T SUBSETS IN INTRAVENOUS-DRUG-USERS WITH HIV-1 INFECTION
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DOI：
10.1001/jama.267.12.1631
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发表时间：
1992-03-25
影响因子：
120.7
通讯作者：
NELSON, KE
中科院分区：
文献类型：
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作者：
MARGOLICK, JB;MUNOZ, A;NELSON, KE
Objective. - 评估流行的人类免疫缺陷病毒1型（HIV-1）血清阴性和血清阳性静脉吸毒者（IVDU）以及已知血清转换时间的HIV-1血清阳性IVDU中T细胞亚群的变化。- 队列研究，中位随访时间为18个月。- 建立以社区为基础的诊所，研究静脉吸毒者艾滋病毒感染的自然史。- 859名年龄在18岁至49岁之间，在过去10年内注射过药物，并且没有AIDS（获得性免疫缺陷综合征）定义疾病的自我介绍的IVDU; 152名HIV-1血清阴性，621名血清阳性，86名在研究期间血清转化。- 淋巴细胞和CD 3、CD 4和CD 8 T细胞的比例和绝对数量，每隔6个月通过流式细胞术和全血细胞计数自动分类测定。- 入组时CD 4淋巴细胞的中位数为血清阴性IVDU为1061/μ-L（1.06 × 10（9）/L），血清阳性IVDU为508/μ-L，血清转化者为733/μ-L（血清转化后中位数为4.5个月入组）; CD 8淋巴细胞的相应数值分别为628、894和889/μ-L。每6个月CD 4淋巴细胞绝对数量和百分比的中位下降率在血清阳性的IVDU中为7.6/μ-L（0.0%），在血清转换的IVDU中为55.1/μ-L（1.9%）（血清转换后的中位随访时间为12个月）。多变量回归分析，包括CD 4淋巴细胞计数的个体内相关性，显示这些细胞随着时间的推移没有显著变化，也没有由于使用药物而发生变化。- 我们的数据表明，HIV-1感染在静脉吸毒者中的进展，如CD 4细胞计数的下降所反映的，并不比其他风险群体报告的更快。
Objective. - To evaluate changes in T-cell subsets in prevalent human immunodeficiency virus type 1 (HIV-1) seronegative and seropositive intravenous drug users (IVDUs) and in HIV-1 seropositive IVDUs with known time of seroconversion.Design. - Cohort study with a median 18-month follow-up.Setting. - Community-based clinic established to study the natural history of HIV infection in IVDUs.Subjects. - Eight hundred fifty-nine self-referred IVDUs aged 18 through 49 years who injected drugs within the last 10 years and who did not have an AIDS (acquired immunodeficiency syndrome)-defining illness; 152 were seronegative for HIV-1, 621 were seropositive, and 86 seroconverted during the study.Outcome Measures. - Proportions and absolute numbers of lymphocytes and CD3, CD4, and CD8 T cells as determined at 6-month intervals by flow cytometry and complete blood cell counts with automated differential.Results. - Median numbers of.CD4 lymphocytes at enrollment were 1061/mu-L (1.06 x 10(9)/L) for seronegative IVDUs, 508/mu-L for seropositive IVDUs, and 733/mu-L for those who seroconverted (enrolled a median of 4.5 months after seroconversion); the corresponding figures for CD8 lymphocytes were 628, 894, and 889/mu-L, respectively. Median rates of decline in absolute numbers and percentages of CD4 lymphocytes per 6 months were 7.6/mu-L (0.0%) for seropositive IVDUs and 55.1/mu-L (1.9%) for IVDUs who seroconverted (median follow-up after seroconversion was 12 months). Multivariate regression analysis that incorporated the within-individual correlation of the CD4 lymphocyte counts showed no significant change in these cells over time and no change due to use of drugs.Conclusion. - Our data suggest that progression of HIV-1 infection in IVDUs, as reflected in decline of CD4 cell counts, is no more rapid than that reported for other risk groups.