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Arch Intern Med:梅毒与男性HIV感染者中CD4细胞数量快速下降和病毒载量增加相关联

  1. CD4
  2. CD4细胞
  3. HIV
  4. 梅毒
  5. 病毒载量

来源:生物谷 2012-11-19 09:27

根据一篇于2012年7月23日在线发表在Archives of Internal Medicine期刊上的论文,在遭受HIV病毒感染的男性体内,梅毒(Syphilis)与CD4细胞数量的快速减少相关联,也与病毒载量(viral load, VL)增加相关联。

根据一篇于2012年7月23日在线发表在Archives of Internal Medicine期刊上的论文,在遭受HIV病毒感染的男性体内,梅毒(Syphilis)与CD4细胞数量的快速减少相关联,也与病毒载量(viral load, VL)增加相关联。

为了早期梅毒对血清HIV-1 RNA水平和CD4细胞数量的影响,来自法国巴黎公共救助医院(Assistance Publique-Hôpitaux de Paris)的Witold Jarzebowski博士和同事们分析了282名被诊断患上一期梅毒或二期梅毒的被HIV-1感染的男性以及1233名为患上梅毒的男性,在被诊断患上梅毒的日期(index date)之前,他们在年龄、性取向、参与中心和随访期限、免疫学和病毒学状态方面相匹配。

在被诊断患上梅毒的日期(校正优势比为1.87)6个月之后,研究人员观察到27.3%患有梅毒的男性体内病毒载量发生增加,而16.6%未患上梅毒的男性体内病毒载量发生增加。即便病毒载量低于每毫升500拷贝的男性正在接受抗逆转病毒治疗(校正优势比为1.52),患上梅毒也与更高风险发生病毒载量增加相关联。相比于未患上梅毒的那组男性而言,在被诊断患上梅毒的那组男性当中,CD4细胞数量显著性下降(平均下降了28/µL),但是随后又恢复到之前的水平。(生物谷:Bioon.com)

本文编译自Syphilis cuts CD4 counts, ups viral load in HIV-infected men

Effect of Early Syphilis Infection on Plasma Viral Load and CD4 Cell Count in Human Immunodeficiency Virus–Infected Men Results From the FHDH-ANRS CO4 Cohort

Witold Jarzebowski, MD, MSc; Eric Caumes, MD; Nicolas Dupin, MD; David Farhi, MD, MPH; Anne-Sophie Lascaux, MD; Christophe Piketty, MD, PhD; Pierre de Truchis, MD; Marie-Anne Bouldouyre, MD; Ouda Derradji, MD; Jérome Pacanowski, MD; Dominique Costagliola, PhD; Sophie Grabar, MD, PhD; for the FHDH-ANRS CO4 Study Team

Background Concomitant syphilis and human immunodeficiency virus (HIV) infection is increasingly frequent in industrialized countries. Methods From a large hospital cohort of HIV-infected patients followed up in the Paris area between 1998 and 2006, we examined the effect of early syphilis on plasma HIV-1 RNA levels and CD4 cell counts. We compared 282 HIV-1–infected men diagnosed as having incident primary or secondary syphilis with 1233 syphilis-free men matched for age (±5 years), sexual orientation, participating center, length of follow-up (±6 months), and immunologic and virologic status before the date of syphilis diagnosis (index date). Increase in viral load (VL) (plasma HIV-1 RNA) of at least 0.5 log or a rise to greater than 500 copies/mL in patients with previously controlled VL during the 6 months after the index date was analyzed, as were CD4 cell count variations and CD4 slope after the index date. Results During the 6 months after the index date, VL increase was observed in 77 men with syphilis (27.3%) and in 205 syphilis-free men (16.6%) (adjusted odds ratio [aOR], 1.87; 95% CI, 1.40-2.49). Even in men with a VL of less than 500 copies/mL undergoing antiretroviral therapy, syphilis was associated with a higher risk of VL increase (aOR, 1.52; 95% CI, 1.02-2.26). The CD4 cell count decreased significantly (mean, −28/μL) compared with the syphilis-free group during the syphilis episode (P = .001) but returned to previous levels thereafter. Conclusions In HIV-infected men, syphilis was associated with a slight and transient decrease in the CD4 cell count and with an increase in VL, which implies that syphilis may increase the risk of HIV transmission, even in patients receiving antiretroviral therapy and with a VL of less than 500 copies/mL.

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