Shorter survival in advanced human immunodeficiency virus type 1 infection is more closely associated with T lymphocyte activation than with plasma virus burden or virus chemokine coreceptor usage
Shorter survival in advanced human immunodeficiency virus type 1 infection is more closely associated with T lymphocyte activation than with plasma virus burden or virus chemokine coreceptor usage
复制标题
DOI：
10.1086/314660
复制
发表时间：
1999-04-01
影响因子：
6.4
通讯作者：
Detels, R
中科院分区：
文献类型：
--
作者：
Giorgi, JV;Hultin, LE;Detels, R
为了确定晚期人类免疫缺陷病毒1型（HIV-1）疾病生存时间的预测因素，研究了CD 4（+）T细胞降至小于或等于50/mm（3）后的长期和短期存活者。CD 4（+）和CD 8（+）T细胞的免疫活化（通过CD 38抗原的细胞表面表达升高来测量）与较短的后续生存期强烈相关（P小于或等于0.002）。所有受试者中的初始CD 45 RA（+）CD 62 L（+）T细胞储备均较低，并且不能预测生存期（对于CD 4（+）细胞P= 0.34，对于CD 8（+）细胞P = 0.08）。较高的病毒负荷与CD 8（+）细胞活化相关，但与CD 4（+）细胞活化无关，在校正多重比较后，与较短的生存期无关（P=.02），所有患者的病毒均使用CCR 5、CXCR 4或两者，并且辅助受体的使用并不能预测生存率（P= 0.27），通过与较高病毒负荷明显无关的机制，免疫激活是晚期HIV-1疾病生存的主要决定因素。
To define predictors of survival time in late human immunodeficiency virus type 1 (HIV-1) disease, long- and short-duration survivors were studied after their CD4(+) T cells fell to less than or equal to 50/mm(3). Immune activation of CD4(+) and CD8(+) T cells, as measured by elevated cell surface expression of CD38 antigen, was strongly associated with shorter subsequent survival (P less than or equal to.002), The naive CD45RA(+)CD62L(+) T cell reserve was low in all subjects and did not predict survival (P=.34 for CD4(+) and .08 for CD8(+) cells). Higher virus burden correlated with CD8(+) but not CD4(+) cell activation and, after correcting for multiple comparisons, was not associated with shorter survival (P=.02), All of the patients' viruses used CCR5, CXCR4, or both, and coreceptor usage did not predict survival (P=.27), Through mechanisms apparently unrelated to higher virus burden, immune activation is a major determinant of survival in advanced HIV-1 disease.