HIV感染前后血浆CCL3水平变化与疾病进展的关系

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目的 探究HIV感染前后血浆CCL3水平变化、急性期血浆CCL3水平与CD4细胞数量及病毒载量之间的关系,评估其对HIV感染的疾病进展的预测能力.方法 选取中国医科大学附属第一医院红丝带门诊HIV感染者54例,对其感染前和急性期感染的血浆CCL3、CD4细胞数量以及病毒载量进行检测.结果 HIV感染前后CCL3升高倍数高组的病毒载量明显高于升高倍数低组(P=0.006);急性期血浆CCL3水平高组在感染120天和感染1年时的CD4细胞数量均低于CCL3水平低组(P=0.018 2;P=).0013),且急性期血浆CCL3水平与CD4/CD8比值均呈负相关关系(r=-0.562 0,P=0.000 4;r=-0.614 4,P=0.000 4);ROC曲线分析显示CCL3升高倍数对感染120天的病毒载量的预测价值为75.2%(P=0.021 4),Kaplan-Meier生存分析显示CCL3升高倍数高于1.215的HIV感染者,其发生高病毒载量(lg拷贝/mL≥4)结局事件所用时间更短(P=0.010 3);ROC曲线分析显示急性期血浆CCL3水平对感染1年的CD4细胞数量和病毒载量水平的预测价值为81.25%(P=0.035 7),Kaplan-Meier生存分析显示急性期血浆CCL3水平高于2.855pg/mL的HIV感染者,其感染120天后发生低CD4细胞数(<500个/μL)和高病毒载量(lg拷贝/mL≥4)的结局事件所用时间更短(P=0.019 2).结论 HIV感染前后血浆CCL3水平升高倍数大及急性期血浆CCL3水平表达高预示着HIV感染者较快的疾病进展.
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