新确诊HIV阳性患者弓形虫感染血清学调查及影响因素分析

Seroprevalence and related factors of toxoplasma gondii infection among HIV- positive patients recently diagnosed

目的调查弓形虫免疫球蛋白M（immunoglobulin M,Ig M）、免疫球蛋白G（immunoglobulin G,Ig G）和循环抗原（circulating antigen,CAg）血清阳性率,分析广西地区新确诊的HIV阳性患者弓形虫感染现况和影响因素。方法选取2011年1月1日-2012年12月31日广西某艾滋病自愿咨询检测门诊新确诊的全部HIV阳性患者,剔除之前曾接受艾滋病抗病毒治疗以及相关机会性感染预防药物治疗的患者。收集个案信息并抽取静脉血,检测弓形虫Ig M、Ig G、CAg和CD4＋T淋巴细胞计数,探讨HIV阳性患者弓形虫感染的相关影响因素。结果弓形虫Ig M阳性率为0.00%（0/234）,Ig G阳性率为26.07%（61/234）,CAg阳性率为26.92%（63/234）。双阳性率（Ig G及CAg均阳性）为6.84%（16/234）。新确诊的HIV阳性患者弓形虫Ig G阳性率与CD4＋T淋巴细胞计数和居住地有关。结论建议对所有新确诊的HIV阳性患者检测弓形虫Ig G,针对CD4＋T淋巴细胞计数〈100 cell/mm3的患者和来自农村患者采取重点预防措施。

Objective To investigate seropositivity rate of toxoplasma gondii immunoglobulin M（ Ig M）,immunoglobulin G（ Ig G） and circulating antigen（ CAg） and find the related factors among HIV-positive patients who were recently diagnosed. Methods Participants were selected from a HIV voluntary consulting testing clinic in Guangxi who were first diagnosed between January 1st,2011 and December 31 st,2012 and had not received any HIV antiviral treatments and any opportunistic infection treatments. Sera from 234 participants were tested with enzyme-linked immunosorbent assay,which detected toxoplasma gondii Ig M,Ig G and CAg. The results of Ig M,Ig G,CAg tests and individual information were analyzed by univariate and multivariate non-conditional logistic regression. Results The seropositivity rates of Ig M,Ig G and CAg were 0. 00%（ 0 /234）,26. 07%（ 61 /234） and 26. 92%（ 63 /234）,respectively. The seropositivity rate of Ig G and CAg together was 6. 84%（ 16 /234）. The seropositivity rate of Ig G was associated with the level of CD4＋T lymphocyte count and place of residence. Conclusions It is recommended that all HIV- positive patients recently diagnosed should be screened with toxoplasma gondii Ig G test. Patients with the CD4＋T lymphocyte count less than 100 cell / mm3 and from rural should be raised further concerns.