Detections Ofil-2, Il-4, And CD4~+ CD25~+ Regulatory T Cells In Patients With Leprosy And HIV Co-infected And Its Clinical Significance

Objective:Leprosy is a chronic infectious disease caused by Mycobacterium leprae.By 2010,the global number of registered cases with leprosy had been 211,903.Since the first case was reported of AIDS worldwide in 1981, the number of HIV infections has risen to about 33.4million. The rate of HIV infection in highly endemic areas of leprosy is rising.It is proved that HIV infection can trigger the infections of Mycobacterium tuberculosis and other mycobacterium.In the cases with HIV and TB co-infection, HIV infection can activate tuberculosis and accelerate its course.Mycobacterium leprae also belongs to mycobacterium, so leprosy and HIV infection may interact. In view of leprosy and HIV infection being reported limitedly, there is a dispute whether there are mutual influences. In this study through detecting and contrasting the differences of IL-2,IL-4,CD4+CD25+ regulatory T cells among leprosy group,HIV infection group, leprosy and HIV co-infection group and control group,we investigated whether leprosy and HIV infection have relationships and reveal the correlation of leprosy and HIV infection in highly endemic areas, which provide a scientific basis for decision made for the prevention and control of leprosy and HIV.Methods:The subjects were divided into four groups,Leprosy group of 10 patients,HIV infection group of 9 patients, leprosy and HIV infection co-infection of 3 patients; normal controls of 9 persons; we detected four groups of CD4, CD8 and CD4+CD25+ regulatory T cells by flow cytometry; plasma IL-2, IL-4 level by double antibody sandwich ELISA; viral load by HIV-RNA of quantitative assay and used SPSS 13.0 package for statistical analysis. Results:(1) The levels of IL-2 in leprosy group, HIV infection group, leprosy and HIV co-infection group and control group was no statistical significance (p=0.088>0.05).(2) The levels of IL-4 in leprosy group, HIV infection group, leprosy and HIV co-infection group and control group was no statistical significance (p= 0.341>0.05).(3)When CD4+ T cell count<200/μl, HIV infection group with CD4+CD25+ regulatory T cells was statistically higher compared with normal control group(P=0.006<0.05). (4) CD4+CD25+ regulatory T cells and CD4+cells was negatively correlated (r=-0.783, P=0.013 <0.05). (5).HIV infection viral load and CD4+CD25+regulatory T cells was positively correlated(r=0.952,P=0.000<0.01). (6) leprosy group with CD4+CD25+ regulatory T cells was statistically higher than normal control group (P=0.028<0.05). Conclusion:1. In leprosy group, HIV infection group, leprosy and HIV co-infection group and the control group,IL-2 and IL-4 levels of in each group showed no statistical significance, which was concerned with our choice of cases.Because CD4+T cell count in the HIV group were more than 200/μl, HIV infected patients we chosed were not significantly weaken the cell-mediated immunity. Leprosy patients may be related to the implementation of MDT therapy. On account of MDT therapy, the immune functions of leprosy patients was gradually recovery.2.When the CD4 cell count <200/μl, HIV infection group with CD4+CD25+ regulatory T cells was higher compared with normal controls;when the CD4+ T cell count>200/μl,there was no statistical difference between the two groups, indicating that CD4+CD25+ regulatory T cells increase in number of cells associated with disease progression, and in the terminal stage of HIV infection,CD4+CD25+ regulatory T cells involved in inhibition of HIV-specific T cell function, contributing to the elevated viral replication,resulting in the host immune injury.3.CD4 +T cells and CD4+CD25+regulatory T cells was negatively correlated in HIV infection group (P<0.05),HIV infection viral load and CD4+CD25+regulatory T cells was positively correlated (P<0.01), indicating that increased frequency of CD4+CD25+ regulatory T cells may play a facilitating role on progression of HIV-infected patients.4. Leprosy groups with CD4+CD25+ regulatory T cells was higher compared with normal controls, indicating that CD4+CD25+ regulatory T cells involved in the leprosy of cellular immunity by inhibiting T cell activation and proliferation, to avoid too strong immune response against its own tissue damage. CD4+CD25+ regulatory T cells in leprosy and HIV co-infection group (when CD4+ T cell count> 200/μl),comparing with normal control group, the leprosy group, and HIV infection (CD4+T cell count>200/μl),the difference was not statistically significant. These findings suggest HIV infection may had no effect on the CD4+CD25+ regulatory T cells in patients with leprosy.5.In this study, we need further studies because of the small sample size.