Study on the changes of CD_(28) and soluble CD_(27) and their clinical significance among HIV-1-infected chinese patients receiving highly active antiretroviral therapy

Objective To observe the changes of CD_(28) and soluble CD_(27)(sCD_(27)) among HIV-1-infected Chinese patients receiving highly active antiretroviral therapy(HAART) and to explore their clinical significance.Methods The HIV-RNA viral load(VL) and cell counts of CD_3~+CD_4~+,CD_3~+CD_8~+,CD_4~+CD_(45)RA~+CD_(62)L~+,CD_4~+CD_(28)~+,CD_8~+CD_(28)~+ and the content of sCD_(27) were determined in 28 cases of HIV-1-infected patients at the baseline and 12,24 and 48 weeks respectively after the treatment with three drug regimens based on two nucleoside reverse transcriptase inhibitors(NRTIs) and an Non-NRTI(NNRTI) for 1 year.Results The average of HIV-RNA VL before the treatment was 5.25 logs,and decreased to 3.30,1.92 and 1.74 logs after the treatment for 12,24 and 48 weeks respectively.The cell counts of CD_3~+CD_4~+,CD_3~+CD_8~+,CD_4~+CD_(45)RA~+62L~+,CD_4~+CD_(28)~+,CD_8~+CD_(28)~+ before the treatment were(236±85),(917±345),(58±15),(175±63) and(285±87) cells/μl,and changed into(327±112),(803±343),(114±25),(286±132) and(387±201) cells/μl after the treatment for 48 weeks respectively.The content of sCD_(27) decreased from(475±123) U/ml to(174±77) U/ml after the treatment for 48 weeks.The HIV RNA VL had significantly negative correlation with cell counts of CD_4~+T,CD_4~+CD_(28)~+ and CD_8~+CD_(28)~+,and there was positive correlation between HIV RNA VL and the level of sCD_(27).Conclusion The immune reconstitution and activation depend on the efficacy of antiretroviral therapy.The HIV RNA VL and cell counts of CD_4~+T are the representative parameters of immunologic and viral responses of HAART.The cell counts of CD_4~+CD_(28)~+ and CD_8~+CD_(28)~+ and their percentages show concomitant changes with viral load,and play an effective role in the progression and prognosis of AIDS.The level of sCD_(27) is positively correlated with HIV RNA VL and negatively with counts of CD_4~+T cell.The detection of sCD_(27) by enzyme linked immunosorbent assay(ELISA),which is much more convenient and cheaper than RT-PCR and flow cytometry,may serve as an important parameter to judge the pathogenetic condition of HIV-1-infected patients and to examine the therapeutic effects of HAART in the medical resource-limited area.