Detection of HIV-1 in Urine of HIV-Infected Patients Without Antiviral Therapies
Detection of HIV-1 in Urine of HIV-Infected Patients Without Antiviral Therapies
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未接受抗病毒治疗的 HIV 感染者尿液中 HIV-1 的检测
DOI：
10.1089/aid.2017.0017
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发表时间：
2017
影响因子：
1.5
通讯作者：
Zhao H. L.
中科院分区：
文献类型：
--
作者：
Qiao Y. C.;Xu Q.;Wei J. C.;Ling W.;Pan Y. H.;Zhao H. L.
方法收集桂林市第三人民医院艾滋病门诊16例HIV-1感染者，经抗病毒治疗后均为阴性。获得当地研究伦理委员会的伦理批准。患者提供了他们第一次晨尿样本的中段。尿样在6小时内处理，置于冰箱中，并在-20 ℃下保存1个月（36至85 ml）。从这些血液样品中分离血浆和外周血单核细胞，并用于病毒载量测量和CD 4 + T细胞计数。使用流式细胞术（BD FACSAria III，圣何塞，CA）对外周CD 4+细胞进行计数。使用RealTime HIV-1检测试剂盒（Abbott Laboratories SA，Guangzhou，China）同时检测尿液和血液中的HIV-1 RNA。Abbott Laboratories提供的试验具有5-log 10线性范围和100%的试验特异性。检测下限为50拷贝/ml。尿液中HIV-1 RNA的浓度高于50拷贝/ml被认为是positive.Results5例患者尿液HIV-1 RNA阳性（表1）。在3名患者的新鲜尿液样本中发现高浓度的HIV-1 RNA（871，000、150，500和100，200拷贝），而在2名患者中检测到低浓度（472.2和214.4拷贝）。新鲜尿液样本中的病毒载量为224，477 ± 164，223（平均值±SD）拷贝，配对血液样本中的病毒载量为11，560 ± 6，695拷贝（p=. 147）。尿HIV-1载量与血HIV-1病毒载量或CD 4+细胞计数无统计学显著相关性。在3例尿HIV-1 RNA浓度高的患者中，2例在开始抗逆转录病毒治疗前1个月内死亡。相比之下，11例尿液阴性患者在12个月的临床观察期内均未死亡。
MethodsSixteen HIV-1-infected patients negative to antiretroviral therapy were enrolled in AIDS clinics of the Guilin Third People's Hospital. Ethical approval was obtained from the local research ethics committee. The patients gave the midstream of their first morning urine samples. The urine samples were processed within 6 h, placed in a refrigerator, and maintained at− 20 C for 1 month (36 to 85 ml). Plasma and peripheral blood mononuclear cells were isolated from these blood samples and used for viral load measurement and CD4+ T cell counts. Peripheral CD4+ cells were counted using flow cytometry (BD FACSAria III, San Jose, CA). HIV-1 RNA in urine and blood was concurrently detected with a RealTime HIV-1 assay (Abbott Laboratories SA, Guangzhou, China). The assay shown from Abbott Laboratories has a 5-log10 linear range and assay specificity of 100%. The lower detection limit of the assay is 50 copies/ml. The concentration of HIV-1 RNA in urine with higher than 50 copies/ml was considered as positive.ResultsFive patients were urine positive for HIV-1 RNA (Table 1). High concentration of HIV-1 RNA in fresh urine samples was found in three patients (871,000, 150,500, and 100,200 copies), whereas low concentration was detected in two patients (472.2 and 214.4 copies). Viral load was 224,477±164,223 (mean±SD) copies in fresh urine samples and 11,560±6,695 copies in paired blood samples (p=. 147). There was no statistically significant correlation of urine HIV-1 load with blood HIV-1 viral load or CD4+ cell count. Among the three patients who had high concentration of urine HIV-1 RNA, two died within 1 month of enrollment before initiation of antiretroviral treatment. In contrast, none of the 11 urine negative patients died within a period of 12-month clinical observation.