早期梅毒对HIV感染者CD4^+ T细胞计数的影响

Influence of early syphilis on CD4 cell count in humanimmunodeficiency virus infection

目的分析在男男性接触人群中早期梅毒对HIV感染者外周血CD4细胞计数的影响。方法在男男性接触人群中建立HIV感染者新发早期梅毒的研究队列,确诊梅毒后给予苄星青霉素治疗。应用流式细胞仪检测梅毒感染前、感染期间和成功驱梅治疗后3个月、6个月的外周血CD4细胞,运用重复测量方差分析,分别对比梅毒感染前与感染期间、感染期间与成功驱梅治疗后3个月、6个月CD4的变化。结果 HIV合并早期梅毒感染者共50例,其中有45例驱梅治疗成功。与梅毒感染前相比,感染期的CD4计数降低(P=0.04);驱梅治疗后3个月CD4计数较感染期升高,但差异无统计学意义(P>0.05);治疗后6个月CD4计数较感染期显著升高(P=0.02),差异有统计学意义。结论梅毒螺旋体的早期感染使HIV感染人群的CD4计数下降,而成功的驱梅治疗可以逆转这一趋势。

Objective To assess the effect of early syphilis on CD4 cell count among men who have sex with men（MSM） with human immunodeficiency virus（HIV） infection.Methods Cases of early syphilis in HIV infected patients among MSM were included.Benzathine penicillin was given after the diagnosis of syphilis.CD4 cell counts were measured by flow cytometry before,during,and after three and six months of treatment,and the results were compared.Results Fifty patients were included,and forty-five patients had successful treatment of syphilis.CD4 cell count decreased significantly during infection in patients with early syphilis（P=0.04）.There was no significant difference in the levels of CD4 cell during infection and after the 3-month treatment（P0.05）,and CD4 cell count increased significantly during infection and after the 6-month treatment（P=0.02）.Conclusion CD4 cell count decreased in the early infection with Treponema pallidum in HIV infected patients,and the successful treatment of syphilis can reverse the trend.