Immunological markers of disease progression in patients infected with the human immunodeficiency virus
Immunological markers of disease progression in patients infected with the human immunodeficiency virus
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DOI：
10.1128/cdli.4.4.474-477.1997
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发表时间：
1997-07-01
期刊：
影响因子：
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通讯作者：
Amador, A
中科院分区：
文献类型：
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作者：
Pascale, JM;Isaacs, MD;Amador, A
在80%的HIV感染者居住且医疗预算较低的发展中国家，鉴定可用于预测人类免疫缺陷病毒(HIV)感染患者发展为艾滋病的廉价且技术简单的免疫学检测尤其受欢迎。在本研究中，我们评估了74名巴拿马HIV阳性患者和50名HIV阴性健康人的CD_4(+)和总淋巴细胞计数以及血清中β(2)-微球蛋白、p24抗原和免疫球蛋白A浓度作为疾病进展的预测因子。艾滋病患者的总淋巴细胞和CD_4(+)细胞计数(1,451+/-811细胞/亩，L，P<；无症状患者分别为2,393+/-664个/亩，L，0.001和784+/-475个/亩，L，P<；0.0001；0.001)明显低于健康人(2,596+/-631个/亩L和1,120+/-296个/亩L)。艾滋病患者血清β(2)-微球蛋白和免疫球蛋白水平显著升高(5.70+/-3.6 mg/L，P<；0.0001和541+/-265 mg/dl，P<；无症状感染者分别为0.0001.4+/-2.1 mg/L和4 36+/-2 16 mg/dl，P<；0.0001；而健康人分别为2.2+/-0.7 mg/L和2 0 4+/-113 mg/dl。差异无统计学意义(P>；无症状感染者(29+/-13pg/ml)和艾滋病患者(40+/-23mU/ml)之间p24抗原浓度，淋巴细胞总数<1750个/亩L，CD_4<200个/亩L，血清β(2)-微球蛋白浓度>4 mg/L，血清IgA450 mg/dl或更高，p24抗原存在与发生艾滋病的风险增加相关，监测淋巴细胞总数和β(2)-微球蛋白均为91%；这些检测可能会减少每年进行的CD4(+)细胞评估的数量，以及与监测HIV阳性患者的免疫状态相关的成本。
Identification of inexpensive and technically simple immunological tests useful in predicting the progression to AIDS in human immunodeficiency virus (HIV)-infected patients would be especially welcome in developing countries, in which 80% of the HIV-infected patients reside and health budgets are low, In the current study, we evaluated CD4(+) and total lymphocyte counts and the concentrations in serum of beta(2)-microglobulin, p24 antigen, and immunoglobulin A (IgA) as predictors of disease progression in 74 Panamanian HIV-positive patients and 50 HIV-negative healthy individuals, Total lymphocyte and CD4(+)-cell counts for AIDS patients (1,451 +/- 811 cells/mu l, P < 0.001, and 238 +/- 392 cells/mu l, P < 0.0001, respectively) and asymptomatic patients (2,393 +/- 664 cells/mu l, P > 0.05, and 784 +/- 475 cells/mu l, P < 0.001, respectively) were lower than those observed for healthy subjects (2,596 +/- 631 cells/mu l and 1,120 +/- 296 cells/mu l, respectively), The levels of beta(2)-microglobulin and IgA in serum were significantly elevated in patients with AIDS (5.7 +/- 3.6 mg/liter, P < 0.0001, and 541 +/- 265 mg/dl, P < 0.0001, respectively) and asymptomatic infected subjects (3.4 +/- 2.1 mg/liter, P = 0.001, and 436 +/- 216 mg/dl, P < 0.0001, respectively) compared with the levels in healthy subjects (2.2 +/- 0.7 mg/liter and 204 +/- 113 mg/dl, respectively). Nonstatistically significant differences (P > 0.05) for concentrations of p24 antigen between asymptomatic infected patients (29 +/- 13 pg/ml) and AIDS patients (40 +/- 23 mu g/ml) were observed, Total lymphocyte counts of 1,750 cells/mu l or less, CD4 counts of 200 cells/mu l or less, beta(2)-microglobulin concentrations in serum of 4 mg/liter or higher, concentrations of IgA in serum of 450 mg/dl or higher, and the presence in serum of p24 antigen were correlated with elevated risks for developing AIDS, monitoring both total lymphocytes and beta(2)-microglobulin identified 91% of the AIDS patients; these assays may allow reductions in the annual number of CD4(+)-cell evaluations and the costs associated with monitoring the immune status of HIV-positive patients.