摘要
目的探讨血清维生素D水平对人类免疫缺陷病毒1型(HIV-1)感染者的影响。方法选取2021年1月至2023年7月长沙市第一医院接受HIV-1 DNA检测的经治HIV-1感染者411例,对其中92例维生素D缺乏的感染者进行补充试验,并按自愿原则分为研究组(42例)和对照组(50例)。分析不同特征HIV-1感染者维生素D缺乏情况,比较2组血清维生素D水平、T细胞亚群水平、HIV-1 DNA水平,并分析血清维生素D水平与T细胞亚群、HIV-1 DNA水平相关性。结果不同年龄段、抗反转录病毒治疗(ART)疗程、CD8^(+)T细胞计数水平及CD4/CD8比值HIV-1感染者血清维生素D缺乏率比较,差异有统计学意义(P<0.05)。≥40岁HIV-1感染者维生素D缺乏率明显低于<40岁感染者,差异有统计学意义(P<0.05)。血清维生素D水平与CD8^(+)T细胞计数水平呈负相关(r=—0.2510,P<0.05),与CD4/CD8比值呈正相关(r=0.1726,P<0.05),而与CD4^(+)T细胞计数水平无显著相关性(P>0.05)。血清维生素D水平与HIV-1 DNA水平呈负相关(r=—0.1022,P<0.05),与ART疗程呈正相关(r=0.1274,P<0.05)。2组基线血清维生素D、T细胞亚群水平比较,差异无统计学意义(P>0.05)。随访48周时,研究组血清维生素D、CD4^(+)T细胞计数、CD8^(+)T细胞计数水平高于基线时,差异有统计学意义(P<0.05),而对照组仅维生素D水平高于基线时(P=0.007),CD4^(+)T、CD8^(+)T细胞计数水平和CD4/CD8比值与基线时比较,差异无统计学意义(P>0.05)。随访48周时,研究组血清维生素D、CD8^(+)T细胞计数水平高于对照组,差异有统计学意义(P<0.05)。结论青年和ART早期的HIV-1感染者血清维生素D水平相对较低,补充维生素D3可改善其免疫功能,降低病毒储存水平。
Objective To investigate the influence of serum vitamin D levels on individuals infected with human immunodeficiency virus type 1(HIV-1).Methods A total of 411 treated HIV-1 infected patients undergoing HIV-1 DNA testing at the First Hospital of Changsha from January 2021 to July 2023 were included.Among them,92 infected individuals with vitamin D deficiency were subjected to supplementary test and divided into study group(42 cases)and control group(50 cases)according to voluntary basis.Analysis included assessment of vitamin D deficiency across different demographic and clinical characteristics of HIV-1 infected individuals,comparison of serum vitamin D levels,T-cell subset levels,and HIV-1 DNA levels between the two groups,and correlation analysis of serum vitamin D levels with T-cell subsets and HIV-1 DNA levels.Results Significant differences in serum vitamin D deficiency rates were observed among HIV-1 infected individuals across different age groups,antiretroviral therapy(ART)durations,CD8^(+)T-cell counts,and CD4/CD8 ratios(P<0.05).Individuals aged≥40 years exhibited significantly lower rates of vitamin D deficiency compared to those aged<40 years(P<0.05).Serum vitamin D levels were negatively correlated with CD8^(+)T-cell counts(r=-0.2510,P<0.05),positively correlated with CD4/CD8 ratios(r=0.1726,P<0.05),and showed no significant correlation with CD4^(+)T-cell counts(P>0.05).Serum vitamin D levels were negatively correlated with HIV-1 DNA levels(r=-0.1022,P<0.05)and positively correlated with ART duration(r=0.1274,P<0.05).There were no statistically significant differences in baseline serum vitamin D levels and T-cell subset levels between the study and control groups(P>0.05).At the 48-week follow-up,the study group showed significantly higher levels of serum vitamin D,CD4^(+)T-cell counts,and CD8^(+)T-cell counts compared to baseline(P<0.05),whereas the control group exhibited only higher serum vitamin D levels compared to baseline(P=0.007).Comparison of CD4^(+)T-cell counts,CD8^(+)T-cell counts,and CD4/CD8 ratios between the two groups at 48 weeks did not show statistically significant differences(P>0.05).At the 48-week follow-up,the study group had significantly higher serum vitamin D and CD8^(+)T-cell counts compared to the control group(P<0.05).Conclusion Younger individuals and those in early stages of ART with HIV-1 infection tend to have relatively lower serum vitamin D levels.Supplementation with vitamin D3 may improve immune function and reduce viral reservoir levels.
作者
彭勇权
曹旭健
汪雅婷
曾紫微
余维维
王敏
PENG Yongquan;CAO Xujian;WANG Yating;ZENG Ziwei;YU Weiwei;WANG Min(Graduate Collaborative Training Base,the First Hospital of Changsha and Hengyang Medical College,University of South China,Hengyang,Hunan 421001,China;The Institute of HIV/AIDS,the First Hospital of Changsha,Changsha,Hunan 410005,China)
出处
《现代医药卫生》
2024年第15期2521-2525,2532,共6页
Journal of Modern Medicine & Health
基金
湖南省创新型省份建设专项经费资助项目(2020SK21361)。
