江苏省男性HIV阳性者支原体感染及免疫功能分析

Pathogenic mycoplasmas infection and cellular immune function in males with HIV infection in Jiangsu province

目的调查男性艾滋病病毒(HIV)阳性者的支原体感染情况,探索支原体感染与HIV阳性者免疫功能状况之间的关系。方法问卷调查人口学特征、临床表现、高危行为史等基本信息;采集首段尿检测解脲脲原体(Uu)、人型支原体(Mh)、生殖支原体(Mg)、发酵支原体(Mf)、穿通支原体(Mpe)和梨支原体(Mpi);采集外周静脉血检测CD4+、CD8+T淋巴细胞计数水平及白介素-2(IL-2)、白介素-4(IL-4)、白介素-6(IL-6)、白介素-10(IL-10)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)表达水平。结果江苏省男性HIV感染者中Uu、Mh、Mg、Mf、Mpe、Mpi的感染率分别为51.7%(257/497)、34.0%(169/497)、29.0%(144/497)、6.6%(33/497)、1.6%(8/497)、16.3%(81/497);男性HIV感染者中CD4+T细胞<200个/μL有108例,占21.8%,200～499个/μL有252例,占50.9%;外周血中IL-2、IL-4、IL-6、IL-10、IFN-γ、TNF-α含量中位数分别为145.059、1.315、0.420、2.405、4.083、7.157 ng/mL;感染了艾滋病相关支原体的男性HIV感染者外周血的CD3+、CD4+、CD8+细胞计数水平以及TNF-α的表达水平均明显低于未感染艾滋病相关支原体的男性HIV感染者。结论 6种致病性支原体在江苏省男性HIV感染者体内均有不同程度感染,可能与机体免疫功能状况存在关联,应引起临床足够重视。

Objective To investigate the prevalence of Ureaplasma ruealyticum（Uu）,Mycoplasma hominis（Mh）,Myoplasma genitalium（Mg）,Myoplasma fermentas（Mf）,Myoplasma penetrans（Mpe）,and Myoplasma pirum（Mpe） infection and to explore the relation between mycoplasma infection and immune function among males with human immunodeficiency virus（HIV） infection.Methods A questionnaire survey was conducted to collect related information.The first void urine was collected to detcet Uu,Mh,Mg,Mf,Mpe,Mpi and venous blood samples were collected to measure peripheral blood T lymphocytes and Th1/Th2 cytokines.EXCEL and SPSS 11.5 were adopted in data analysis.Results The infection rates of Uu,Mh,Mg,Mf,Mpe,Mpi among the males were 51.7,34.0,29.0,6.6,1.6,and 16.3%,respectively,and the ratio of the males with CD4＋ cells count less than 200/μL was 21.8% and 50.9% of the male with the count of CD4＋ cells between 200 and 500/μL.Among the males,the median level（ng/mL） of interleukin-2,interleukin-4,interleukin-6,interleukin-10,interferon-γ,and tumor necrosis factor-α（TNF-α） was 145.059,1.315,0.420,2.405,4.083,7.157,respectively.The levels of CD3＋,CD4＋,CD8＋,and TNF-α of the males with AIDS-associated mycoplasmas infection were significantly lower than those of without the infection（UCD3=2.86,P=0.004;UCD4=2.73,P=0.006;UCD8=2.40,P=0.017;UTNF-α=2.71,P=0.007）.Conclusion Infections of 6 pathogenic mycoplasmas exist among males with HIV infection and the infection may be associated with host immune function and should be concerned in clinical practice.