The Effect Of Highly Active Antiretroviral Therapy On The Lymphocyte Subsets And Functions From The Peripheral Blood Of HIV-Ⅰ Infected People

Background:Acquired immunodeficiency syndrome (AIDS) is a severe infective disease caused by human immunodeficiency virus (HIV). It is a secondary immunodeficiency disease in which the cellular immunodeficiency is predominant. HIV destroy the human immunologic system, impair the immunological defense function. The pathogenic process of HIV is very complicated. Besides the primary attack of CD4~+T lymphocytes, it involves in many kinds of human immunocytes, such as mononuclear-phagocytes, B lymphocytes, CD8~+T lymphocytes, NK cells. The mechanism is so various and complicated, thus lead to the dysfunction of human immunologic system, initiation of a series of intractable opportunistic infections and malignant tumors. Up to now there is no therapeutic drug which is highly active and low poisonous in worldwide. Through many years' clinical exploration and observation, it is manifested by practice that the most effective therapy to treat the ADIS patients is combined therapy. This reasonable and effective combined therapy, which is called highly active antiretroviral therapy, is making use of three or four or even five kinds of bioactive drugs, to break down the cellular pathologic function of HIV , to inhibit the duplication of the virus, and eliminate the virus surviving in many cells of lymphoid tissues and other parts. The aim of the therapy is :to reduce the virus load most extent and for a long time, reconstruct the immunologic function, reduce the morbidity and mortality of the HIV referred disease.CD4~+T lymphocytes are the target cells of the HIV infection. Thus the peripheral blood CD4~+T lymphocyte count is an important index which can measure the process of HIV infection and therapeutic effect of the anti-HIV drug. Meanwhile other lymphocytes are damaged in different extent. It can be reflected by the change of number and function in different extent. Besides that, after the HIV infection, the expression of cytokines can be different from the healthy people. The expression of cytokines has ongoing dysregulation as the HIV infection develops .The cytokines play a key role in the process of HIV infection, have important effect on the prognosis of the disease. We try to seek some lymphocyte subset indexes and some cytokine indexes which can reflect the immunologic function of HIV infected patients and the therapeutic effect of HAART through the detection of the lymphocyte subsets of HIV infection people by flow cytometry as well as through the detection of the cytokines by enzyme linked immunosorbent assay (ELISA)..Objective:To study the effect of HIV infection and HAART on the lymphocytes through the detection of peripheral blood lymphocyte subsets expression and the detection of the serum cytokines expression in the AIDS patients and healthy controls, in AIDS patients before and after HAART.Methods:Analyze the expression and percentage of peripheral blood CD4~+CD45RA~+, CD4~+CD45RO~+, CD4~+CD28~+, CD8~+CD38~+, CD4~+CD25~+, CD8~+CD25~+, CD4~+CD95~+, CD8~+CD95~+, and CD14~+, CD19~+, CD56~+ lymphocytes by flow cytometry two color fluorescence staining and relative count methods, the levels of the serum cytokines were analyzed by ELISA in 30 healthy control and 41 AIDS patients, in 21 AIDS patients before and after HAART.Results:1. The percentage of CD4~+CD45RA~+,CD4~+CD28~+,CD4~+CD45RO~+,CD4~+CD95~+ lymphocytes of peripheral blood in AIDS patients was much more lower(P<0.01), the percentage of CD8~+CD95~+,CD8~+CD38~+,CD56~+ lymphocytes was higher than in healthy controls (P≤0.01);2. After HAART, the percentage of CD4~+CD45RA~+,CD4~+CD28~+ lymphocytes increased (P<0.01), the percentage of CD8~+CD38~+ and CD56~+T lymphocytes reduced (P<0.01), compared with that before HAART;3. The expression of the serum IL-10 and TGF -β1 in AIDS patients was higher than in healthy controls (P<0.01);4. After HAART, the expression of serum IL-10 reduced (P<0.05 ), but was higher than in healthy controls; the expression of serum TGF -β1 reduced (P<0.01) .Conclusions:1. The lower immunologic function exists in HIV-1 infected people who are infected by blood transmission in Henan province. It can be reflected by the reduction of various CD4~+ lymphocyte subsets percentage, and the increase of serum IL-10 and TGF -β1 which have significant inhibitory effect;2.After HAART, the CD4~+CD45RA~+,CD4~+CD28~+,CD8~+CD38~+and CD56~+ lymphocytes retrieved, the serum IL-10 and TGF -β1 levels descended, suggest that HAART is effective and these immunologic indexes can reflect the development of AIDS and the effect of HAART.