Cohort Study on the Influence of Opportunistic Infectious Pathogens on the Distribution of Peripheral Blood T Lymphocyte Subsets in Newly Acquired AIDS Patients During Antiretroviral Therapy

Shan HUANG; Song-qin LV; Hong-fen DUAN; Jin-li SHI; Guang-min LI; Gang HUANG; Jia-neng LI; Xiao-fei LI

doi:10.12259/j.issn.2095-610X.S20211128

Volume 42 Issue 11

Nov. 2021

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Shan HUANG, Song-qin LV, Hong-fen DUAN, Jin-li SHI, Guang-min LI, Gang HUANG, Jia-neng LI, Xiao-fei LI. Cohort Study on the Influence of Opportunistic Infectious Pathogens on the Distribution of Peripheral Blood T Lymphocyte Subsets in Newly Acquired AIDS Patients During Antiretroviral Therapy[J]. Journal of Kunming Medical University, 2021, 42(11): 159-165. doi: 10.12259/j.issn.2095-610X.S20211128

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Cohort Study on the Influence of Opportunistic Infectious Pathogens on the Distribution of Peripheral Blood T Lymphocyte Subsets in Newly Acquired AIDS Patients During Antiretroviral Therapy

doi: 10.12259/j.issn.2095-610X.S20211128

The Third People’s Hospital of Kunming/Clinical Centre for Infectious Diseases in Yunnan Province，Kunming Yunnan 650041，China

Received Date: 2021-10-15
Available Online: 2021-11-16
Publish Date: 2021-11-30

Abstract

Abstract

Objective To investigate the influence of opportunistic infectious pathogens on the distribution of peripheral blood T lymphocyte subsets in newly acquired AIDS patients during efficient antiretroviral therapy. Methods A total of 220 AIDS patients who were first diagnosed and not performed with antiviral treatment in Infectious Disease Department I of Kunming Third People's Hospital from January 1, 2019 to June 30, 2020 were collected. According to clinical diagnosis, out of 220 patients, 33 patients had AIDS combined with mycobacterium tuberculosis, 30 patients had AIDS combined with hepatitis C virus, 31 patients had AIDS with Talaromyces marneffei, 45 patients had AIDS combined with 1 pathogens, 30 patients had AIDS with 2 pathogens, and 51 patients had AIDS with 3 or more pathogens. The treatment regimen was Tenofovir disoproxil fumarate tablets + lamivudine + EFV （TDF + 3TC + EFV）. Anticoagulant samples were collected before treatment, 3, 6 and 12 months after treatment. The peripheral blood T lymphocyte subsets were detected by flow cytometry. The distribution of peripheral blood T lymphocyte subsets in each group during antiviral treatment was compared and analyzed. Results The counts of CD3⁺, CD8⁺ and CD4⁺T lymphocyte in 3 groups of patients including the patients with AIDS combined with mycobacterium tuberculosis （AIDS/TB）, the patients with AIDS combined with hepatitis c virus （AIDS/HCV） and the patients with AIDS combined with Talaromyces marneffei （AIDS/TM） were significantly increased after 3 months treatment, and the differences were of statistical significance （P < 0.05）. As for AIDS/TM group, the CD4⁺T lymphocyte count increased significantly after 6 months of treatment; As for the other two groups, there was no obvious change of 3 indexes in the subsequent treatment, and the difference was statistically significant. （P > 0.05）. There was no significant difference in the count of CD3⁺ and CD8⁺ T lymphocytes in the three groups after 1 year of treatment, and the difference was of no statistical significance （P > 0.05）; The CD4⁺ T lymphocyte count in AIDS/HCV group was higher than that of the other two groups, and the difference was statistically significant （P < 0.05）. The CD3+ and CD8⁺T lymphocyte counts increased significantly after 3 months of antiviral treatment in the group of AIDS with 1 pathogen （AIDS/1）, and the difference was statistically significant （P < 0.05）. There was no significant change in CD4⁺T lymphocyte count during the whole treatment period, and the difference was no statistically significant （P > 0.05）. The CD8⁺T lymphocyte counts after treatment for 6 months and the CD3⁺ lymphocyte counts after treatment for 3 months in the group of AIDS with 2 pathogens increased significantly, and the difference was statistically significant （P < 0.05）. The CD3⁺ and CD8⁺T lymphocyte counts increased significantly after 6 months of treatment in the group of AIDS with 3 or more pathogens （AIDS/≥3）; The CD4⁺T lymphocyte count of AIDS/2 and AIDS/≥3 groups increased significantly after 3 and 6 months of treatment, and the difference was statistically significant （P < 0.05）. After one year of treatment, there was no significant difference in CD3⁺ and CD8⁺T lymphocyte counts among the three groups, and the difference was no statistically significant （P > 0.05）; The CD4⁺T lymphocyte count of AIDS/1 group was higher than that of the other two groups, and the difference was statistically significant （P < 0.05）. The ratio of CD4⁺/CD8⁺ in 6 groups was less than 1. Conclusions After the standardized efficient antiretroviral therapy, the counts of CD3⁺ and CD8⁺T lymphocytes in the peripheral blood of AIDS patients can be restored to the same level, regardless of the type and quantity of opportunistic pathogens. The distribution level of T lymphocyte subsets in the AIDS patients before and after treatment and the type and quantity of opportunistic pathogens will affect the recovery rate and level of CD4⁺T lymphocyte count during treatment. Three months before the efficient antiretroviral treatment is the key period to evaluate the therapeutic effect, while CD4/CD8 is not an ideal evaluation index.
- Acquired immune deficiency syndrome,
- Opportunistic infection,
- T lymphocyte subset specificity,
- Highly active antiretroviral therapy

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