pmjТихоокеанский медицинский журналPacific Medical Journal1609-1175TGMU10.17238/PmJ1609-1175.2018.4.15-19pmj-274Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHESУглубление дефицита наивных T-клеток CD4+ у пациентов с ВИЧ-инфекцией при коинфицировании вирусом гепатита CDeficit deepening of naive T-cells CD4+ in patients with HIV infection when co-infected with hepatitis C virusШмагельК. В.ShmagelK. V.noemail@neicon.ruКоролевскаяЛ. Б.KorolevskayaL. B.noemail@neicon.ruСайдаковаЕ. В.SaydakovaE. V.noemail@neicon.ruШмагельН. Г.ShmagelN. G.shmagel@iegm.ruПермский федеральный исследовательский центр УрО РАНРоссияPerm Scientific Centre of the Ural Branch of the Russian Academy of SciencesRussian FederationПермский федеральный исследовательский центр УрО РАН; Пермский краевой центр по профилактике и борьбе со СПИД и инфекционными заболеваниямиРоссияPerm Scientific Centre of the Ural Branch of the Russian Academy of Sciences; AIDS Prevention CentreRussian Federation201828122018041519Copyright © Шмагель К.В., Королевская Л.Б., Сайдакова Е.В., Шмагель Н.Г., 20182018Шмагель К.В., Королевская Л.Б., Сайдакова Е.В., Шмагель Н.Г.Shmagel K.V., Korolevskaya L.B., Saydakova E.V., Shmagel N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tmj-vgmu.ru/jour/article/view/274

У пациентов, инфицированных вирусом иммунодефицита человека (ВИЧ), коинфицированных вирусом гепатита C и получающих антиретровирусную терапию, в большей степени, чем у ВИЧ-моноинфицированных субъектов, выражен дефицит наивных T-клеток CD4+. Показано, что их недостаточность связана с уровнем активации иммунитета, активностью гепатита и степенью нарушения целостности печеночного барьера для микробных продуктов кишечника. Разные по степени зрелости наивные T-клетки CD4+ имеют различную зависимость от процессов, вызванных гепатитом. Деструкция печеночной ткани больше влияет на недавних выходцев из тимуса. Рост концентрации бактериального ли-пополисахарида в крови сопровождается снижением численности зрелых наивных T-лимфоцитов CD4+. Полученные данные не раскрывают механизмы формирования дефицита наивных CD4+-клеток при коинфекции.

Objective. In patients infected with the human immunodeficiency virus (HIV) and co-infected with the hepatitis C virus (HCV), CD4+ T-cell deficiency is more pronounced compared to HIV monoinfected subjects, due to a reduction in their naive subpopulation. This work is devoted to establishing the causes of the development of insufficiency of these cells. Methods. Two groups of HIV-infected persons were examined: HIV+HCV+ (n=21) and HIV+HCV- (n=21) receiving antiretroviral drugs for more than two years (HIV level <50 copies/ml). Anti-HCV therapy was not conducted. The control group (n=20) consisted of uninfected volunteers. The number of naive CD4+ T cells, the proportion of these included RTE (recent thymic emigrants; CD31+), the content of activated CD4+ T-lymphocytes (HLA-DR+ CD38+), the concentration in the blood of bacterial lipopolysac-charide, the activity of transaminases. Results. Immune activation negatively affected the number of naive CD4+ T cells in both groups of HIV-infected. However, only in the HIV+HCV+ group the inverse relationship between the activity of transaminases, on the one hand, and the proportion of RTE on the other hand (RALT-RTE =-0.590, p<0.005 and RAST-RTE=-0.468, p<0.05), and also the level of lipopolysaccharide and the number of mature (CD31-) naive CD4+ T-lymphocytes (R =-0.535, p<0.02). Conclusions. Thus, hepatitis activity and increased microbial translocation from the intestine in HIV/HCV co-infection may have a negative effect on the number of naive CD4+ T cells. Naive elements of varying degrees of maturity are apparently affected. Specific mechanisms for the formation of a deficit of naive CD4+ T-lymphocytes in HIV/HCV-co-infected individuals have yet to be established.

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The authors declare that there are no conflicts of interest present.