HIV感染者和AIDS患者合并梅毒感染病例的流行病学特征

Epidemiological characteristics of HIV/AIDS combined with syphilis infection

目的了解人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者(HIV/AIDS)合并梅毒感染的流行情况及梅毒对HIV/AIDS的影响,为AIDS的防治提供参考依据。方法收集2011年1月1日—2015年12月31日湘潭市新发现并随访到的463例HIV感染者/AIDS病例的基本信息、采集血液样本进行首次CD4^+T淋巴细胞检测、采用TP-ELISA(梅毒螺旋体-酶联免疫吸附试验)和TPPA(梅毒螺旋体明胶颗粒凝集试验)检测梅毒感染情况,统计分析不同人群的合并梅毒感染率、CD4^+T淋巴细胞计数结果。结果 463例HIV/AIDS合并梅毒感染率与性传播比率存在显著性正相关(R=0.955、P<0.05);463例HIV感染者/AIDS病例合并梅毒感染率为26.35%;男性(30.13%)高于女性(19.25%)(P<0.05);农民工(34.88%)高于商业服务(12.77%)和其他人群(13.33%)(P<0.01);男男传播人群(42.03%)高于异性接触感染人群(27.18%)(P<0.05);性传播组感染人群(29.89%)高于其他组感染人群(10.59%)(P<0.01);CD4^+T淋巴细胞数≤200个/μl层的HIV/AIDS病例合并梅毒感染(39.53%)高于CD4^+T淋巴细胞201~≥501个/μl(21.26%)3层的HIV/AIDS(P<0.01)。结论 HIV/AIDS多合并梅毒感染,已成为梅毒感染的高危人群,在防治工作中应采取综合措施防止HIV/AIDS的梅毒感染、传播,在治疗中要针对梅毒感染情况进行综合治疗。

[Objective] To understand the epidemic situation of syphilis infection among people living with HIV/AIDS,analyze the influence of syphilis infection on this population, and provide the reference for prevention and treatment of AIDS.[Methods]463 people with HIV/AIDS,who were newly detected and followed up from January 1,2011 to December 31,2015 in Xiangtan City,were enrolled in the study to collect the basic information,and their blood samples were collected to perform the initial detection of CD4~＋T lymphocyte. Treponema pallidum-enzyme linked immunosorbent assay（TP-ELISA） and Treponema pallidum gelatin particle agglutination test（TPPA）were used to detect the syphilis infection. The co-infection rate of syphilis and CD4~＋T lymphocyte count in different populations were analyzed statistically. [Results]There was significant positive correlation between co-infection rate of syphilis and rate of sexually transmitted infection in 463 people with HIV/AIDS. The co-infection rate of syphilis in 463 people with HIV/AIDS was 26.35%. The co-infection rate of syphilis in males（30.13%）was higher than that in females（19.25%）（P〈0.05）,the co-infection rate in migrant workers（34.88%） was higher than that in commercial service workers service（12.77%） and other groups（13.33%）（P〈0.01）,the co-infection rate in men who have sex with men（42.03%）was higher than that in heterosexual population（27.18%）（P〈0.05）,and the co-infection rate in sexually transmitted infection group（29.89%） was higher than that in other groups（10.59%）（P〈0.01）.The co-infection rate of syphilis in HIV/AIDS patients whose CD4~＋T lymphocyte count was ≤200 cells/μl（39.53%） was higher than that in those whose CD4 ~＋T lymphocyte count was201~≥501 cells/μl（21.26%）（P〈0.01）. [Conclusion]Most of people with HIV/AIDS are infected with syphilis,and they have become a high-risk group for syphilis infection. The prevention and control work should take comprehensive measures to prevent syphilis infection and transmission among people with HIV/AIDS,and the comprehensive treatment should be carried out according to the situation of syphilis infection.