Assessing the association between platelets and immune recovery in HIV/HBV co-infected patients: A long-term cohort in Asia
Assessing the association between platelets and immune recovery in HIV/HBV co-infected patients: A long-term cohort in Asia
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评估 HIV/HBV 合并感染患者血小板与免疫恢复之间的关系：亚洲的长期队列
DOI：
10.1016/j.meegid.2020.104480
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Hu Feng-Yu
中科院分区：
文献类型：
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作者：
Nie Yuan;Lan Yun;Deng Xi-Zi;Li Lin-Hua;Cai Wei-ping;Li Feng;Hu Feng-Yu
背景既往研究已报道血小板计数与B型肝炎病毒（HBV）所致肝病的进展有关，但尚未报道血小板计数是否与HIV/HBV合并感染患者的免疫恢复有关。方法回顾性分析167例HIV感染者，其持续高效抗逆转录病毒治疗（HAART）策略为拉米夫定+替诺福韦酯+依法韦仑，其中75例为HIV/HBV合并感染者，92例为HIV单一感染者。收集所有患者HAART治疗前的生化检查结果和人口学特征，并获得HAART治疗后各时间点的血常规检查结果（包括血小板计数）和免疫细胞计数（包括CD 4细胞计数）。所有患者观察至72个月。以HAART治疗后72个月CD 4细胞计数为350或500个/μl作为判断免疫重建效果的界限。HAART期间所有患者均具有良好的病毒应答（HIV RNA <20 copies/ml，HBV DNA < 100 copies/mL）和免疫应答。HIV/HBV合并感染者免疫功能恢复差的血小板水平也明显低于免疫功能恢复好的患者。但在HIV单一感染者中未发现这种现象。结论HIV/HBV合并感染者HAART治疗后血小板计数与CD 4计数呈相关性，HAART治疗后血小板计数与CD 4计数呈负相关，HAART治疗后血小板计数与CD 4计数呈负相关。这些结果表明，与血小板减少症相关的机制可能参与调节HIV/HBV合并感染患者治疗后的免疫恢复。
BackgroundPrevious studies have reported that platelet count is associated with the progression of liver disease caused by hepatitis B virus (HBV), but there have been no reports on whether platelet count is associated with immune recovery in HIV/HBV co-infected patients.MethodsA retrospective analysis was conducted on 167 HIV-infected patients whose continuously highly active antiretroviral therapy (HAART) strategy was lamivudine +tenofovir+ efavirenz, of which 75 were HIV/HBV co-infected patients and 92 were HIV mono-infected patients. The biochemical examination results and demographic characteristics of all patients before HAART were collected, and routine blood test results (including platelet count) and immune cell count (including CD4 cells count) after all time points of HAART were obtained. All patients were observed until 72 months. CD4 cells count of 350 or 500 cells/μl 72 months after HAART served as the boundary for judging the immune reconstruction effect.ResultsThe basic characteristics of HIV/HBV co-infected patients and HIV mono-infected patients were matched. All patients had a good viral response (HIV RNA <20 copies/ml, HBV DNA < 100 copies/mL) and immune response during HAART. The platelets with poor immune recovery in HIV/HBV co-infected patients were also maintained at an apparent lower level than that in patients with good immune recovery. However, this phenomenon was not found in HIV mono-infected patients. The platelet level at many time points after HAART therapy in HIV/HBV co-infected patients can predict the effect of immune recovery at 72 months after HAART.ConclusionThe platelet counts of HIV/HBV co-infected patients were correlated with CD4 counts during the follow-up of HAART. These results suggest that the mechanisms associated with thrombocytopenia may be involved in the regulation of immune recovery after treatment in HIV/HBV co-infected patients.