Evaluation of mental status HIV-infected patients: implications for treatment

OBJECTIVES

The aim of the study was to explore factors that may influence mental health status of HIV-infected patients, and to figure out a method that could effectively classify the patients by evaluating the severity of their mental health problems.

METHODS

Eighty-five patients were recruited and divided into two groups: the low risk group (LRG, n = 38) and the high risk group (HRG, n = 47). All patients finished Symptom Check-List 90 Revised (SCL-90-R) which is a multidimensional questionnaire designed to screen for a broad range of psychological problems.

RESULTS

SCL-90-R scores of HRG were significantly higher than those of the general population and did not differ from those of psychosomatic outpatients. Scores of LRG were significantly lower than those of psychosomatic outpatients and did not differ from those of the general population in most subscales. HIV-infected men having sex with men and unemployed patients had much higher incidence of mental health problems.

CONCLUSION

Besides undistinguishable group psychotherapy, we call for a clinical screening by psychological questionnaires at the first step, and then at-risk or high-risk patients should be given corresponding and individualized treatments. More attention and health care should be given to HIV-infected men who have sex with men and unemployed patients.

The Impact of Highly Active Antiretroviral Treatment on the Blood Profiles of Patients with Acquired Immune Deficiency Syndrome

This study retrospectively investigated the short- and long-term impact of highly active antiretroviral treatment (HAART) on the blood profiles of patients with acquired immune deficiency syndrome (AIDS), and their relationship with disease progression. CD4+ T-cell count was measured by flow cytometry, plasma viral load of human immunodeficiency virus (HIV) RNA was detected by reverse transcription—polymerase chain reaction, and blood profile was determined by an automated analyser. CD4+ T-cell count, total lymphocyte count (TLC) and haemoglobin concentration improved gradually in patients with AIDS after the initiation of HAART. Long-term effective HAART significantly increased CD4+ T-cell counts TLC and haemoglobin concentrations, and reduced viral load to undetectable levels. An increase in haemoglobin was positively correlated with an increase in CD4+ T-cells. These findings suggest that TLC is a valuable tool for determining the initiation of HAART, and that the haemoglobin concentration could be an additional indicator for long-term monitoring of HAART in resource-limited settings.

Construction of expression vector of hTERT- hIL18 fusion gene and induction of cytotoxic T lymphocyte response against hTERT

AIM

Recombiant human telomerase reverse transcriptase (hTERT)-human IL-18(hIL18) was constructed to investigate its expression and biological function in eukaryotic cells. DCs transfected with hTERT-IL18 acquired stronger telomerase activity and were able to elicit an hTERT-specific cytotoxic T lymphocyte CTL response in vitro.

METHODS

hIL-18 gene fragment was amplified by polymerase chain reaction (PCR) and TA cloned. The hIL-18 gene was then subcloned into eukaryotic expression vector pcDNA3.1(+) containing human TERT via a linker. The sequence of gene fusion was confirmed using both restrictive enzyme digestion and DNA sequencer. The expression vector with gene fusion was transfected into 3T3 cell line with Lipofectamine 2000. ELISA, Western blot, immunofluorescence stain were performed to determine the expression properties of hTERT-hIL18 in 3T3 cells. Its biological effect on the anti-apoptosis was measured by Flow cytometry and its effect on INF-gamma expression was determined using ELISA. After preparation of dendritic cells, hTERT-hIL18, hTERT, hIL-18 expression vectors were transfected into DCs respectively by electroporation to generate hTERT-specific DCs lines. The peripheral blood mononuclear cells PBMCs were stimulated with different DCs lines to create specific CTL. The response of target cell (leukemia cell line-K562 cell) to hTERT-specific CTL was evaluated by LDH release assay.

RESULTS

The human IL-18 gene fragment was amplified from the human mononuclear cells and was inserted into pcDNA3.1(+)/hTERT vector successfully. The correct sequence was proved by both restrictive enzyme digestion and sequencing. The correct open reading frame was also verified. Fusion protein of hTERT-hIL18 was effectively expressed in eukaryotic cells, which was detected by both Western-blotting and immunofluorescence stain. The expressed recombinant fusion protein induced similar levels of INF-gamma to that of native IL-18 protein. FCM assay showed that the transfected fusion protein inhibited the apoptosis, which was consistent with the effects of hTERT as a universal tumor associated antigen. CTL assay shows that hTERT- hIL18 and hTERT gene-transfected DCs stimulated T-cell responses that recognized and lysed tumor target cells of high hTERT expression, whereas DCs transfected with hIL-18 gene didn't induced the response of tumor targets lyses.

CONCLUSION

The Recombinant hTERT- hIL18 fusion protein had both biological activity of hTERT and hIL-18, indicating that this rationally designed protein can be further developed as novel tumor therapeutics. DCs transfected with hTERT-IL18 gene were capable of eliciting a stronger hTERT-specific CTL response in vitro.