HIV in Tears Despite ART? 抗病毒治疗后眼泪中存在HIV?
In a research letter to be published in AIDS, a Beijing team shows that HIV-1 RNA remains detectable in tears from a majority of patients despite effective ART. This observation raises the possibility that lacrimal glands and/or other tear-associated tissues are a new reservoir for HIV.
在AIDS期刊即将付印的一期中,有一篇研究信,讲述北京的一个团队发现HIV-1型病毒的RNA在大多数病人(虽然已经进行了有效的抗病毒治疗)的泪液中仍然可被检测到。这项观察提出泪腺及/或其它跟眼泪有关的组织可能是HIV的新的“储蓄库”。
This cross-sectional study involved 21 HIV-1 infected subjects (16 with successful plasma viral load suppression for at least 3 months, 2 ARV-naïve subjects and 3 with viral failure) and 5 controls (1). These patients did not have any clinical ophthalmic symptoms and a specific examination at this level was normal in each case.
这项多区段研究涉及到21名HIV-1型病毒感染者,其中16人经过抗病毒治疗已经实现血液中病毒载量抑制3个月以上,2人刚刚开始治疗,3人治疗失败,另有5个HIV阴性对照。这些病人没有任何眼部的临床症状,而且对每个人都进行了详细的检查。
Both qualitative and quantitative PCR were performed. HIV-1 RNA was measured in tear samples by bDNA in all cases and, in 7 cases, by TaqMan. The tear HIV-1 load was 5,181 ± 7,283 copies/ml in the 16 subjects with undetectable viral load in plasma (for 27.2 ± 14.3 months) and 4,477 ± 5,276 copies/ml in the 5 patients with detectable viremia (difference not significant). No positive detection was found in controls.
研究中采用了定性和定量PCR检测,并采用bDNA技术对所有人的泪液样本进行了HIV-1RNA的测定,其中7个案例还采用了TaqMan检测。16个血液病载检测不到的病人(治疗时间为27.2月±14.3个月)的泪液HIV-1载量为5,181 ± 7,283 拷贝/ml,血液病载可测得的5名病人中的泪液HIV-1载量为4,477 ± 5,276 拷贝/ml(有差异但不显著)。对照组中没有检测出HIV-1RNA。
We asked Professor Taisheng Li, principal investigator of this study, a few questions:
我们向该项研究的主要负责人李太生教授提出了几个问题。
Alain Lafeuillade: How did you come to study this body fluid? 您为什么想到研究泪液?
Taisheng Li: We wanted to collect tear to separate HIV material and sequence env, gag or pol genes. The aim was to compare the differences of HIV genome sequences among tear, plasma and PBMCs.我们本来想收集泪液从中分离HIV的成分并做相关的几个基因测序的,其目的是用于比较泪液、唾液和外周血单核细胞中的HIV基因序列的差异。
AL: How did you collect these tears and what was the average amount of liquid you obtained? 您是如何收集泪液样本的?平均样本量是多少?
TL: After informed consent, clinical nurse specialists and psychologist influenced patients mood to induce burst into tears. Technician collected these tears as soon as possible with RNase-free tip and tube. About 0.5ml-1.5ml tear collected from per patient was stored at -80 centigrade freezer for HIV-1 viral load assay. 在获得知情同意后,专业护士和心理学家通过影响病人的情绪来引起病人流泪,检验人员则用无核糖核酸酶的拭子和试管立刻收集他们的泪液。每个病人大约采集到0.5-1毫升的泪液,并储藏在摄氏零下80度的环境下以用于HIV-1病载检测。