Effect of long-term highly active antiretroviral therapy in restoring HIV-induced abnormal B-lymphocyte function
Effect of long-term highly active antiretroviral therapy in restoring HIV-induced abnormal B-lymphocyte function
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DOI：
10.1097/00126334-200212150-00003
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发表时间：
2002-12-15
影响因子：
3.6
通讯作者：
Ng, V
中科院分区：
文献类型：
--
作者：
Jacobson, MA;Khayam-Bashi, H;Ng, V
虽然高效抗逆转录病毒疗法（HAART）已被报道，以恢复细胞介导的免疫缺陷的显着程度，很少有人知道它在恢复HIV诱导的异常抗体介导的免疫的影响。我们进行了一项横断面研究：1）29名接受慢性HAART治疗的HIV感染患者，其HIV病毒载量检测不到，其绝对CD 4（+）T淋巴细胞计数持续超过HAART治疗前的最低值150个细胞/穆尔>1年; 2）29名未接受治疗的HIV感染患者，其当前CD 4计数与治疗患者之前的最低CD 4计数相匹配。检测血清中的总IgG，并通过免疫固定的蛋白电泳检测副蛋白。尽管接受长期病毒学有效HAART治疗的患者血清IgG水平显著低于CD 4计数匹配的未治疗患者，（1488 +/- 475 mg/dL vs. 1999 +/- 775 mg/dL，p = .004），尽管平均28个月的HAART诱导的HIV抑制和CD 4计数恢复，但45%的未治疗组的血清IgG仍然异常升高。在每组中7%的患者中通过免疫固定证实副蛋白峰。这项研究提供了迄今为止HAART对HIV诱导的异常抗体介导的免疫的影响的最长报告观察。需要更大规模和更长期的HAART对B细胞重建的影响研究。
Although highly active antiretroviral therapy (HAART) has been reported to restore defects in cell-mediated immunity to a significant degree, little is known of its effects in restoring HIV-induced abnormal antibody-mediated immunity. We conducted a cross-sectional study of 1) 29 HIV-infected patients on chronic HAART whose HIV viral load was undetectable and whose absolute CD4(+) T-lymphocyte count had been consistently sustained by 150 cells/muL over their pre-HAART nadir value for >1 year; and 2) 29 untreated HIV-infected patients with current CD4 counts matching the treated patients' prior nadir CD4 counts. Serum was tested for total IgG and by protein electrophoresis with immunofixation for paraproteins. Although serum IgG levels were significantly lower in patients who had received long-term virologically effective HAART than in CD4 count-matched untreated patients (1488 +/- 475 mg/dL vs. 1999 +/- 775 mg/dL, p = .004), serum IgG was still abnormally elevated in 45% of the untreated group despite a mean 28 months of HAART-induced HIV suppression and CD4 count restoration. Paraprotein spikes were confirmed by immunofixation in 7% of patients in each group. This study provides the longest reported observation to date of the effect of HAART on HIV-induced abnormal antibody-mediated immunity. Larger and longer-term studies of HAART effect on B-cell reconstitution are needed.