Dynamic Changes And Its Clinical Significance Of HIV-1 DNA In PBMC Of HIV-1 Infected Patients During Highly Active Antiretroviral Therapy

Objective:The purpose of this study was to investigate the dynamic changes and significance of HIV-1 DNA in peripheral blood mononuclear cells(PBMC)of HIV-1 infected patients when plasma HIV-1 RNA was effectively inhibited lower than the detection limit during highly active antiretroviral therapy(HAART).Methods:(1)All the subjects were from the second outpatient department of infectious diseases department of the first affiliated hospital of guangxi medical university.The diagnostic criteria were in line with the 2015 version of the AIDS diagnosis and treatment guides.The patients were receiving HAART with good compliance,and the plasma HIV-1 RNA was less than 20 copies/mL(lower than the detection limit)for the first time when they were included in the study.(2)When plasma HIV-1 RNA was less than 20 copies/mL for the first time(defined as negative),plasma HIV-1 RNA was negative for one year,and plasma HIV-1 RNA was negative for two years,respectively,10mL of peripheral venous blood was collected from patients,and whole blood,plasma and PBMC were retained for further test and analysis.The content of HIV-1 DNA in PBMC of the patients was detected by fluorescence quantitative PCR,and the dynamic changes of HIV-1 DNA content at three different time were compared by one-way anova and pairwise comparison.(3)The patients were divided into group A and group B according to different treatment schemes,namely,there were 23 cases of the first-line regimen of 3TC+TDF+EFV(group A)and 11 cases of the second-line regimen of 3TC+TDF+LPV/r or 3TC+TDF+LPV/r(group B).Independent sample t-test was used to compare the differences of HIV-1 DNA content in PBMC of patients with different HAART regimens at the same time.(4)The patients were divided into group A and group B according to the time from HAART initiation to plasma HIV-1 RNA was negative for the first time.There were 24 patients in group A of the time were needed less than or equal to 6 months,and 10 patients in group B of the time were needed more than 6 months.Independent sample t-test was used to compare the differences of HIV-1 DNA content in PBMC of the patients between the two groups at the same time.(5)To investigate the correlation between HIV-1 DNA content in PBMC of the patients and CD4+/CD8+T lymphocyte counts in peripheral blood of the patients who were receiving HAART for a long time.To describe the dot plot with bivariate linear correlation and make statistical analysis of the correlation.Results:(1)The patients were receiving HAART for a long time,when the plasma HIV-1 RNA was inhibited lower than the detection limit(less than 20 copies/mL),HIV-1 DNA could still be detected in PBMC,and the detection rate was 100%.The average content of HIV-1 DNA in PBMC of the patients was 2.88+0.50 log10 copies/106 cells after plasma HIV-1 RNA was negative for the first time.The average content of HIV-1 DNA in PBMC of the patients was 2.58±0.47 log10 copies/106 cells after plasma HIV-1 RNA was negative for one year.The average content of HIV-1 DNA in PBMC of the patients was 2.57±0.43 log10 copies/106 cells after plasma HIV-1 RNA was negative for two years.The results showed that during HAART the content of HIV-1 DNA in PBMC of the patients decreased gradually when the plasma HIV-1 RNA was inhibited lower than the detection limit.The decrease was most obvious in the first year after plasma HIV-1 RNA was negative,and then it decreased slowly.Moreover,HIV-1 DNA could still be detected in PBMC of the patients after plasma HIV-1 RNA was negative for two years.(2)Among the 15 patients in the control group without HAART,the plasma HIV-1 RNA was all positive,with the average content of HIV-1 RNA was 4.66±0.48 log10 copies/mL,and the average content of HIV-1 DNA in the PBMC of the patients was 3.26±0.56 log10 copies/106 cells.Among the 34 patients who receiving HAART for a long time,the average content of HIV-1 DNA in PBMC of the patients was 2.88 ± 0.50 log10 copies/106 cells after plasma HIV-1 RNA was negative for the first time,the average content of HIV-1 DNA in PBMC of the patients was 2.58±0.47 log10 copies/106 cells after plasma HIV-1 RNA was negative for one year,the average content of HIV-1 DNA in PBMC of the patients was 2.57±0.43 log 10 copies/106 cells after plasma HIV-1 RNA was negative for two years.These results suggest that compared with the untreated group,the patients who receiving HAART for a long time have a lower content of HIV-1 DNA in PBMC,and there was a statistical difference between the two groups.(3)The effect of different HAART regimens on the content of HIV-1 DNA in PBMC of the two groups at the same time was compared by independent sample t-test,and the results showed that there is no significant difference between the two groups,P>0.05.(4)The time was need more than 6 months from the initiation of HAART to the conversion of plasma HIV-1 RNA to negative,and the content of HIV-1 DNA in PBMC of the patients was higher,P<0.05.(5)There was no significant correlation between the content of HIV-1 DNA in PBMC and CD4+/CD8+T lymphocyte counts in peripheral blood of patients with long-term HAART.Conclusion:(1)PBMC HIV-1 DNA can still be detected in HIV-1 infected patients when the plasma HIV-1 RNA was lower than the detection limit during HAART.(2)The level of HIV-1 DNA in the PBMC of HIV-1 infected patients was decreased gradually during HAART.(3)The level of HIV-1 DNA in the PBMC of HIV-1 infected patients had important clinical significance.