| Objective:Some items of AIDS patients treated by Highly active antiretroviral therapy(HAART) has been analyzed, including clinical side effect, mtDNA copy number, mtDNA damage and mtDNA large deletion. High risk factors of mitochondrial damage, correlation and change tendency between clinical side effect and mitochondrial damage among AIDS patients were studied. In order to provide theoretical basis about early warning and monitor of clinical side effect among AIDS patients treated by HAART.Methods The experimental group of AIDS patients is from April to August in2011at the Outpatient Clinic, the Third People’s Hospital of Kunming, The control group including30cases, they are laboratory researchers comeing from the Chinese academy of sciences kunming institute of animal. Acquisition peripheral anticoagulation venous blood of AIDS patients in baseline and after treatment when follow-up(including1month,3month,6month,9month,12month,15month,18month,24month), collecting clinical background information, laboratory tests, clinical side effects, alteration of therapeutic regimen at the same time. We extract DNA genome, appling Real-time PCR through the double standard curve method to detect copy number and damage rate of mtDNA, appling ordinary PCR to detect mtDNA large deletion. Analysing the specific risk factors and the change tendency of mitochondrial damage combined with clinical data.Results Seventy three AIDS patients were enrolled, which16(22.2%) patients had side effects,39.7%were co-infected with hepatitis virus. The most common side effect was myelosuppression (12.3%), next were live damage (11.0%), drug eruption (5.5%), peripheral neuritis (5.5%), lactic acidosis (1.4%, death) and lipoatrophy (1.4%). With age increasing, the incidence of clinical side effect was higher. The CD4+T lymphocyte counts had respectively increased94cell/μL,44.3cell/μL and34.7cell/μL during0to6months,6to12months and12to24months. The CD4+T lymphocyte counts of AIDS patients infected by intravenous drug user had lower increase than others.HIV/AIDS patients in mtDNA copy number before treatment was247.37±198.35, mtDNA copy number showed a decreasing trend with the duration of treatment, the treatment of24months mtDNA copy number was154.94±253.12. Clinical side effects in patients with mtDNA copy number was significantly decreased, and the clinical side effects occurred in patients with decreased mtDNA copy number was significantly higher than HIV/AIDS patients. Decreased after treatment with hepatotoxic mtDNA copynumber, peripheral neuritis, lactic acidosis and lipoatrophy associated hepatotoxicity in patients with mtDNA copy number was325.48±24.38, treatment January mtDNA copy number was263.27±12.11.4例peripheral neuritis the earliertwo cases occurred in patients with mtDNA copy number53.45±32.11,2cases occurred late in the mtDNA copy number of patients dropped to143.25±41.78. MtDNA copy number of lactic acidosis in patients with lipoatrophypatients and decreased95.23and136.85respectively. Old age, combined hepatitis virus infection in patients withmtDNA copy number decreased significantly.2patients with large deletions, the two cases of liver toxicity, including1patient with peripheral neuritis. Mitochondrial DNA damage rate of24months of follow-up there was no significant change in the dynamic.Conclusions:Clinical side effect was frequent among AIDS patients treated by HAART. These are important causes to death and should be monitored closely. MtDNA has apparently decline in liver toxicity, peripheral neuritis, lactic acidosis and lipoatrophy except of myelosuppression, which can be early warning in clinical side effects, but also to monitor mitochondrial toxicity... |
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