Background Regulatory T cells （Tregs） may play an important role in immunopathology during HIV-1 infection. Transcription factor forkhead box P3 （FoxP3） orchestrates the development of Tregs and is a useful marker to identify this population. Using a FoxP3 phenotype to define Tregs, we investigated the level and phenotype of peripheral blood natural CD4~Tregs and assessed the relationship between the frequencies and absolute numbers of CD4＋Tregs and disease progression among untreated HIV-infected men who have sex with men （HIV^MSM） in China. Methods Fifty-two untreated HIV^＋MSM with CD4^＋T-cell counts of 〈350 cells/μl or 〉350 cells/μl were compared in a cross- sectional study. Twelve age-matched HIV-uninfected MSM and nine patients receiving antiretroviral therapy for at least 1 year were also included. Expression of CD25, CD127, CD45RA, CCR7 and CTLA-4 was assessed on CD4^＋Tregs using polychromatic flow cytometry. Results The percentage of CD4^＋Tregs was increased significantly, whereas CD4^＋Tregs expressed less CTLA-4 in HIV＊MSM compared with controls. CD4^＋Tregs displayed predominantly an effector memory phenotype （CD45RA-CCR7-）, phenotypically distinct from conventional CD4^＋T cells. Moreover, the expansive frequencies of CD4^＋Tregs coincided with lower CD4＋T-cell counts and higher viral loads whereas the absolute numbers of CD4^＋Tregs were associated with higher CD4^＋T-cell counts and lower viral loads. The expansion of Tregs was also associated with CD8^＋T-cell activation. Conclusion Increased proportions and decreased numbers of CD4^＋Tregs are associated with HIV progression, and their functions may impair with the progression of HIV infection.
WANG Wan-haiMING LiangWANG YingKAN Quan-chengZHANG Xiao-yan
由于社会歧视及自愿咨询检测(Volunlary counseling and testing,VCT)的覆盖率等因素,中国艾滋病疫情估计人数和实际检测报告人数之间还存在较大的差异,提示有大量的传染源——艾滋病感染者尚未被发现。在发现传染源后,由于某些客观原因和人员流动等因素的影响,造成部分已发现的传染源管理丢失。国内一些专业的艾滋病防治机构和非政府组织,对此进行了有益的探索和实践,包括提高随访率、科学横向的感染者管理模式、疾病预防控制机构牵头创建感染者纵向社区管理网络的模式,以人文化管理的模式、非政府组织发挥积极作用的模式以及特定场所的管理模式等,该文对其进展加以综述。
