Trends And Correlation Of HIV-1 DNA Before ART In Acute Hiv Infection And Chronic Hiv Infection

Objective:HIV-1 DNA were measured to determine the viral reservoir in patients with acute infection and chronic infection before initiation of antiretroviral therapy.To explore the differences in HIV-1 DNA levels between patients with acute infection and those with chronic infection,so as to provide assertive evidence for early treatment.At the same time,the correlation between HIV-1 DNA and other common clinical indicators was analyzed to provide theoretical basis for treatment and disease monitoring.Methods:This study was a cross-sectional study.All patients were from the HIV clinic of Changsha first hospital.Based on patients’epidemiological history,HIV-1 antibody seroconversion time,CD4+T cell count,presence of opportunistic infection(OI),etc.,patients were divided into two arms:AHI and CHI.In the light of the clinical stage,AHI Group was divided into two groups:Fiebig I-IV(Group A)and Fiebig V(Group B).The results of leukomonocyte,hepatitis B antibody,hepatitis C antibody,CMV antibody,EBV DNA,HIV-1 RNA and CD4+T cell,CD8+T cell of all patients were collected,the HIV-1 DNA in peripheral blood mononuclear(PBMC)was detected by PCR-Fluorescence Probing.The results were analyzed by SPSS 22.0 software and by Graph Pad Prism8.0.p<0.05 were statistically significant,0.1<|r|<0.3 was weak correlation,0.3<|r|<0.5 is moderately correlated,and 0.5<|r|is strongly correlated.Results:From 2016/10/31 to 2020/11/23,97 HIV-1 infected patients were enrolled in this study,including 50 AHI and 47 CHI patients.The majority of all patients included in this study were men(96%),with sexual transmission predominating(87.6%).In AHI Group,the mean value of HIV-1 RNA was 5.15 lg copies/ml,and the mean value of HIV-1 DNA was 2.83 lg copies/10~6 PBMCs.In CHI group,the mean value of HIV-1 RNA was 4.90 lg copies/ml,and the mean value of HIV-1 DNA was 3.19 lg copies/10~6 PBMCs.HIV-1 DNA in patients with acute infection was lower than that in patients with chronic infection(p=0.002),but HIV-1 RNA in patients with acute infection was higher than that in patients with chronic infection(p=0.183).Except HIV-1 RNA and HIV-1 DNA,there was no significant difference in other clinical features between AHI Group and CHI Group(p>0.05).In AHI Group,there were 24 patients with Fiebig I-IV(Group A)and 26 patients with Fiebig V(Group B).In Group A,HIV-1 RNA was 5.08 lg copies/ml and HIV-1 DNA was 2.54 lg copies/10~6 PBMCs.In Group B,the mean value of HIV-1 RNA was 5.21 lg copies/ml,and the mean value of HIV-1 DNA was 3.09 lg copies/10~6 PBMCs.Comparing the HIV-1 RNA and HIV-1 DNA levels among Group A,B and CHI,Group A and Group CHI had significant differences in HIV-1 DNA levels(p<0.001),Group A and group B had significant differences in HIV-1 DNA levels(p=0.001).And Group A had the lowest HIV-1 DNA level,followed by Group B,the Group CHI had the highest HIV-1 DNA.The correlation analysis of HIV-1 DNA and HIV-1 RNA with other indexes showed that HIV-1 RNA was negatively correlated with CD4+T cell and CD4/CD8 ratio in AHI Group and CHI group(p<0.05),and positively correlated with CD8+T cell(p<0.05),all the above were low to moderate correlation.In Group AHI,HIV-1 DNA was positively correlated with HIV-1 RNA(r=0.548,p<0.001),but not in Group CHI(r=0.14,p=0.347).Conclusions:Before ART,Patients with acute infection have lower HIV-1 DNA levels and smaller viral reservoir than those with chronic infection,providing evidence for early treatment.In patients with acute infection,HIV-1DNA levels were lower in patients with Fiebig I-IV than in patients with Fiebig V,suggesting that HIV-1 DNA levels increased gradually in patients with acute infection and HIV-1 reservoirs existed early.The correlation between HIV-1 DNA and HIV-1 RNA in patients with acute infection is strong,the level of HIV-1 DNA increased with the increase of HIV-1 RNA level.