住院艾滋病患者并发巨细胞病毒感染特点分析

Cytomegalovirus infection among hospitalized AIDS patients in Wuhan city of China

目的分析武汉地区住院艾滋病患者合并巨细胞病毒(CMV)感染特点,比较不同体液标本CMV DNA阳性率及与CMV感染相关的因素。方法采用实时荧光定量PCR法检测患者体液中CMV DNA载量,采用微粒子酶学免疫化学发光法检测血清CMV IgM和IgG,流式细胞术检测患者血CD4+T细胞数。结果 117例住院艾滋病(AIDS)患者中CMV感染患者72例,阳性率为61.5%。血液、唾液、尿液及脑脊液CMV DNA阳性率依次为53.8%、59.2%、56.3%和20.0%。CMV IgM阳性者有8例,阳性率为6.8%,CMV IgG阳性者有59例,阳性率为50.4%。CMV感染患者中CD4+T细胞数低于50个/μl比例多于CMV阴性患者。结论住院艾滋病患者CMV感染阳性率较高,尤其是在血液、尿液及唾液样本中,CMV DNA是合并感染的监测指标。CMV感染多发生于CD4+T细胞低下的患者,感染可引起多器官损害。

Objective To investigate the prevalence of cytomegalovirus infection among hospitalized AIDS patients in Wuhan city of China and compare the CMV DNA positive rates in different body fluid specimens and analyze factors associated with CMV infection. Methods The real-time-PCR assay was used to detect the CMV DNA.The number of CD4＋T cells in peripheral blood and the quantity of blood anti-CMV-IgM/IgG were also detected by flow cytometry and enzymatic immunochemical assays. Results There were 72 positive cytomegalovirus carriers among 117 AIDS patients at the percentage of cytomegalovirus infection 61.5%.The percentages of cytomegalovirus infection in blood/saliva/urine/cerebro-spinal fluid are 53.8%,59.2%,56.3%,and 20.0%,respectively.There were 8CMV-IgM positive patients and 59CMV-IgG positive patients with the positive rate at 6.8%and 50.4%,respectively.The number of patients with CD4＋T cell count lower than 50/μl was more than that of CMV negative patients. Conclusions The positive rate of CMV infection is high in hospitalized AIDS patients,especially in their blood,urine and saliva samples.CMV infection usually occurs in patients whose CD4＋T cells are less than 50/μl and cause multiple organ damage.