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World J Gastroenterol. Apr 28, 2007; 13(16): 2357-2362
Published online Apr 28, 2007. doi: 10.3748/wjg.v13.i16.2357
Study on the blood-borne virus co-infection and T lymphocyte subset among intravenous drug users
Jian-Rong Li, Rui-Yu Gong, Kun-Lun Tian, Jing Wang, Yi-Xin Wang, Han-Ju Huang
Jian-Rong Li, Rui-Yu Gong, Han-Ju Huang, Department of Pathogenic Biology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Kun-Lun Tian, Jing Wang, Yi-Xin Wang, Basic Medical Department, Dali College, Dali 671000, Yunnan Province, China
Author contributions: All authors contributed equally to the work.
Supported by the National Natural Sciences Foundation of China, No. 30160083
Correspondence to: Jian-Rong Li, Department of Pathogenic Biology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China. jrli@mails.tjmu.edu.cn
Telephone: +86-27-83650550 Fax: +86-27-83657829
Received: February 26, 2007
Revised: March 10, 2007
Accepted: March 21, 2007
Published online: April 28, 2007
Abstract

AIM: To investigate the features of various blood-borne virus infections and co-infection in intravenous drug users (IDUs), and to examine the correlation of T lymphocyte subsets with virus co-infection.

METHODS: Four hundred and six IDUs without any clinical manifestation of hepatitis and 102 healthy persons were enrolled in this study. HBV-DNA and HCV-RNA were detected by fluorescence quantitative PCR. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag, anti-HGV, anti-HIV, and HCMV-IgM were assayed by enzyme-linked immunosorbent assay (ELISA) and immunochromatographic tests. The levels of Th1 and Th2 cytokines were measured by ELISA and radioactive immune assay (RIA). The T lymphocyte subpopulation was detected by using fluorescence immunoassay. The similar indices taken from the healthy persons served as controls.

RESULTS: The viral infection rate among IDUs was 36.45% for HBV, 69.7% for HCV, 47.3% for HIV, 2.22% for HDV, 1.97% for HGV, and 3.45% for HCMV. The co-infection rate of blood-borne virus was detected in 255 of 406 (62.81%) IDUs. More than 80% (161/192) of subjects infected with HIV were co-infected with the other viruses, such as HBV, HCV. In contrast, among the controls, the infection rate was 17.65% for HBV and 0% for the other viruses. Our investigation showed that there was a profound decrease in the proportion of CD4/CD8 and the percentage of CD3 and CD4, but not in the percentage of CD8. The levels of PHA-induced cytokines (IFN-γ and IL-4) and serum IL-2 were obviously decreased in IDUs. On the other hand, the level of serum IL-4 was increased. The level of IFN-γ and the percentage of CD4 were continuously decreased when the IDUs were infected with HIV or HIV co-infection. IDUs with HIV and HBV co-infection was 15.1% (29/192). Of those 29 IDU with HIV and HBV co-infection, 51.72% (15/29) and 37.93% (11/29) were HBV-DNA-positive and HBeAg-positive, respectively. But, among IDUs without HIV infection, only 1.68% (2/119) of cases were HBV-DNA-positive.

CONCLUSION: HCV, HBV and HIV infections are common in this population of IDU, leading to a high incidence of impaired Th1 cytokine levels and CD4 lymphocyte. IDUs with HIV and HBV/HCV co-infection have lower expression of Th1 cytokine with enhancement of the Th2 response. HIV may be causing HBV replication by decreasing Th1 function.

Keywords: Intravenous drug users, T lymphocyte subpopulation, Blood-borne virus, Co-infection, Cytokine