艾滋病患者CD4 T细胞计数与机会性感染的关系
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摘要
目的探讨艾滋病(AIDS)患者CD4 T细胞计数与机会性感染的关系。方法选取2015年2月—2017年2月在唐山市传染病医院接受治疗的HIV-1感染的AIDS患者103例,采用流式细胞仪检测CD4 T细胞以及病毒载量,分析其机会性感染发生情况。结果 103例AIDS患者中有90例在住院期间发生机会性感染261例次,感染率为87.38%;口腔假丝酵母菌感染、细菌性肺炎、肺结核发生例次数最多,分别占27.20%、21.46%和16.48%;CD4 T细胞100~200个/μl、50~100个/μl和≤50个/μl的AIDS患者的机会性感染发生率分别为62.96%、81.82%和100.00%,明显高于计数≥200个/μl患者(P<0.05)。CD4 T细胞≤50个/μl的患者口腔假丝酵母感染和细菌性肺炎发生率分别为43.75%和37.50%,明显高于≥200个/μl的患者(P <0.05);CD4 T细胞50~100个/μl的患者细菌性肺炎发生率为13.64%,明显高于≥200个/μl的患者(P <0.05)。不同CD4 T细胞的AIDS患者肺结核、感染性腹泻、卡氏孢子虫肺炎发生率差异无统计学意义(P> 0.05)。CD4 T细胞100~200个/μl、50~100个/μl和≤50个/μl的患者HIV-1病毒载量明显高于CD4 T细胞≥200个/μl的患者(P <0.05)。结论 AIDS患者机会性感染发生率较高,口腔假丝酵母菌感染和细菌性肺炎较常见,且与患者CD4 T细胞计数有一定关系;CD4 T细胞计数与病毒载量有一定关系。
Objective To investigate the relationship between CD4 T cell count and opportunistic infection in AIDS patients.Methods A total of 103 AIDS patients with HIV-1 infection treated in Tangshan Infectious Diseases Hospital from February 2015 to February 2017 were selected,CD4 T cell count and viral load were tested by flow cytometry.The opportunistic infection was analyzed.Results Among 103 AIDScases had 261 opportunistic infections during hospitalization,the infection rate was 87.38%.Candida spp.infection,bacterial pneumonia and pulmonary tuberculosis were the most common cases,accounted for 27.20%and 16.48%.The incidence of opportunistic infection of CD4 T cell in 100-200/μl,50-100/μl and≤50/μl patients was 62.96%and100.00%,which was significantly higher than that of the patients with CD4 T cell≥200/μl(P<0.05).The incidence of oral Candida spp.infection and bacterial pneumonia in patients with CD4 T cell≤50/μl was 43.75%and37.50%,which was significantly higher than that patients with CD4 T cell≥200/μl(P<0.05).The incidence of bacterial pneumonia in patients with 50-100/μl CD4 T cell was 13.64%,which was significantly higher than the patients with≥200/μl CD4 T cell(P<0.05).There was no significant difference in the incidence of pulmonary tuberculosis,infectious diarrhea and sporozoite carinii pneumonia among different CD4 T cell count patients(P>0.05).The HIV-1 viral load of CD4 T cell patients with 100-200/μl,50-100/μl and≤50/μl was significantly higher than that of patients with≥200/μl CD4 T cell(P<0.05).ConclusionThe incidence of opportunistic infections in HIV-1 related AIDS patients was higher,the common infections were oral Candida spp.infection and bacterial pneumonia.The occurrence of opportunistic infections was related to CD4 T cell count,and the number of CD4 T cell was related to viral load of the patients.
Objective To investigate the relationship between CD4 T cell count and opportunistic infection in AIDS patients.Methods A total of 103 AIDS patients with HIV-1 infection treated in Tangshan Infectious Diseases Hospital from February 2015 to February 2017 were selected,CD4 T cell count and viral load were tested by flow cytometry.The opportunistic infection was analyzed.Results Among 103 AIDScases had 261 opportunistic infections during hospitalization,the infection rate was 87.38%.Candida spp.infection,bacterial pneumonia and pulmonary tuberculosis were the most common cases,accounted for 27.20%and 16.48%.The incidence of opportunistic infection of CD4 T cell in 100-200/μl,50-100/μl and≤50/μl patients was 62.96%and100.00%,which was significantly higher than that of the patients with CD4 T cell≥200/μl(P<0.05).The incidence of oral Candida spp.infection and bacterial pneumonia in patients with CD4 T cell≤50/μl was 43.75%and37.50%,which was significantly higher than that patients with CD4 T cell≥200/μl(P<0.05).The incidence of bacterial pneumonia in patients with 50-100/μl CD4 T cell was 13.64%,which was significantly higher than the patients with≥200/μl CD4 T cell(P<0.05).There was no significant difference in the incidence of pulmonary tuberculosis,infectious diarrhea and sporozoite carinii pneumonia among different CD4 T cell count patients(P>0.05).The HIV-1 viral load of CD4 T cell patients with 100-200/μl,50-100/μl and≤50/μl was significantly higher than that of patients with≥200/μl CD4 T cell(P<0.05).ConclusionThe incidence of opportunistic infections in HIV-1 related AIDS patients was higher,the common infections were oral Candida spp.infection and bacterial pneumonia.The occurrence of opportunistic infections was related to CD4 T cell count,and the number of CD4 T cell was related to viral load of the patients.
引文
[1]黄洁,赵川.性传播感染的HIV/AIDS抗病毒治疗CD4~+T淋巴细胞计数和HIV病毒载量结果分析[J].职业与健康,2016,32(22):3140-3142.
[2]杨福春,李川,王建华. HIV-1潜伏感染及功能性治愈[J].中国艾滋病性病,2015,21(11):998-1004.
[3] Dennin RH,Sinn A. The current HIV/AIDS prevention strategies-widely outsmarted by omitting realities:a socio-critical analysis in the context of powerless law,ethics and asymmetric interpretation of human rights[J]. World Journal of AIDS,2015,5(3):275-297.
[4]魏爱旺,陆祥彬,张俊岭. HIV-1抗体阳性者WB带型及首次CD4~+T淋巴细胞检测分析[J].江苏预防医学,2015,26(2):18-19.
[5] Musich T,O’Connell O,Gonzalezperez MP,et al. HIV-1 nonmacrophage-tropic R5 envelope glycoproteins are not more tropic for entry into primary CD4+T-cells than envelopes highly adapted for macrophages[J]. Retrovirology,2015,12(1):25-32.
[6]谢静,邱志峰,韩扬. HIV/AIDS患者外周血CD4+T细胞计数和淋巴细胞计数相关性的多中心研究[J].中华内科杂志,2015,54(2):118-121.
[7] Pantaleo G,Menzo S,Vaccarazza M,et al. Studies in subjects with long-term nonprogressive human immunodeficiency virus infection[J]. N Engl J Med,1995,332(1):209-216.
[8]孔德生,马丽英. HIV的清除和艾滋病功能性治愈的研究进展[J].中国热带医学,2016,16(11):1145-1150.
[9] Anderson JL,Fromentin R,Corbelli GM,et al. Progress towards an HIV cure:update from the 2014 international AIDS society symposium[J]. AIDS Research&Human Retroviruses,2015,31(1):36-44.
[10]王万海,明亮,阚全程.人免疫缺陷病毒1型(HIV-1)感染者CD4~+CD25~+调节性T细胞的研究进展[J].细胞与分子免疫学杂志,2016,32(5):699-702.
[11]李铃,古雪,敬雨佳.人类免疫缺陷病毒,艾滋病病毒1型艾滋病患者CD4+T淋巴细胞水平与机会感染及病毒载量的相关性分析[J].中国现代医学杂志,2016,26(2):13-18.
[12] Claiborne DT,Prince JL,Scully E,et al. Replicative fitness of transmitted HIV-1 drives acute immune activation,proviral load in memory CD4+T cells,and disease progression[J]. Proceedings of the National Academy of Sciences of the United States of America,2015,112(12):1480-1489.
[2]杨福春,李川,王建华. HIV-1潜伏感染及功能性治愈[J].中国艾滋病性病,2015,21(11):998-1004.
[3] Dennin RH,Sinn A. The current HIV/AIDS prevention strategies-widely outsmarted by omitting realities:a socio-critical analysis in the context of powerless law,ethics and asymmetric interpretation of human rights[J]. World Journal of AIDS,2015,5(3):275-297.
[4]魏爱旺,陆祥彬,张俊岭. HIV-1抗体阳性者WB带型及首次CD4~+T淋巴细胞检测分析[J].江苏预防医学,2015,26(2):18-19.
[5] Musich T,O’Connell O,Gonzalezperez MP,et al. HIV-1 nonmacrophage-tropic R5 envelope glycoproteins are not more tropic for entry into primary CD4+T-cells than envelopes highly adapted for macrophages[J]. Retrovirology,2015,12(1):25-32.
[6]谢静,邱志峰,韩扬. HIV/AIDS患者外周血CD4+T细胞计数和淋巴细胞计数相关性的多中心研究[J].中华内科杂志,2015,54(2):118-121.
[7] Pantaleo G,Menzo S,Vaccarazza M,et al. Studies in subjects with long-term nonprogressive human immunodeficiency virus infection[J]. N Engl J Med,1995,332(1):209-216.
[8]孔德生,马丽英. HIV的清除和艾滋病功能性治愈的研究进展[J].中国热带医学,2016,16(11):1145-1150.
[9] Anderson JL,Fromentin R,Corbelli GM,et al. Progress towards an HIV cure:update from the 2014 international AIDS society symposium[J]. AIDS Research&Human Retroviruses,2015,31(1):36-44.
[10]王万海,明亮,阚全程.人免疫缺陷病毒1型(HIV-1)感染者CD4~+CD25~+调节性T细胞的研究进展[J].细胞与分子免疫学杂志,2016,32(5):699-702.
[11]李铃,古雪,敬雨佳.人类免疫缺陷病毒,艾滋病病毒1型艾滋病患者CD4+T淋巴细胞水平与机会感染及病毒载量的相关性分析[J].中国现代医学杂志,2016,26(2):13-18.
[12] Claiborne DT,Prince JL,Scully E,et al. Replicative fitness of transmitted HIV-1 drives acute immune activation,proviral load in memory CD4+T cells,and disease progression[J]. Proceedings of the National Academy of Sciences of the United States of America,2015,112(12):1480-1489.