获得性免疫缺陷综合征患者合并机会性感染的淋巴细胞亚群和HIV-1病毒载量的特点分析

Characteristics of lymphocytes subsets and HIV-1 viral loads in AIDS patients complicated with opportunistic infection

目的分析获得性免疫缺陷综合征(AIDS)患者合并机会性感染的淋巴细胞亚群和HIV-1病毒载量的特点。方法对2019年1-12月于西南医科大学附属医院感染病科住院治疗的100例AIDS患者合并机会性感染195例次的基本信息、感染种类、淋巴细胞亚群计数和HIV-1病毒载量进行分析。结果该地区AIDS患者合并机会性感染以41~65岁已婚男性农民或农民工居多,HIV-1传播途径以异性性行为为主。细菌性肺炎是发病率最高的机会性感染(50/195,25.6%)。根据CD4^+T淋巴细胞计数水平分为4组,随着CD4^+T淋巴细胞计数水平降低,AIDS患者合并机会性感染的发生例数也随之增加。随着CD4^+T淋巴细胞计数水平降低,CD8^+T淋巴细胞、NK细胞和B淋巴细胞计数水平也随之降低。当HIV-1病毒载量较高时,CD4^+T淋巴细胞计数较低;而当HIV-1病毒载量较低时,CD4^+T淋巴细胞计数较高,两者呈负相关(r=-0.297,P=0.014)。结论该地区AIDS患者合并机会性感染的表现复杂多样,CD4^+T淋巴细胞计数水平越低,免疫功能缺陷越明显,机会性感染的发生率越高。随着HIV-1病毒载量上升,CD4^+T淋巴细胞计数呈现下降的趋势。定期监测AIDS患者的淋巴细胞亚群和HIV-1病毒载量,可以预测疾病进展,评估抗病毒治疗疗效,进而预防机会性感染的发生。

Objective To analyze the characteristics of lymphocytes subsets and HIV-1 viral loads in acquired immunodeficiency syndrome(AIDS)patients complicated with opportunistic infection.Methods The clinical data including types of opportunistic infection,lymphocytes subsets and HIV-1 viral loads were analyzed for 100 AIDS patients complicated with opportunistic infection treated in the Department of Infectious Diseases in the Affiliated Hospital of Southwest Medical University from January 2019 to December 2019.Results Majority of the AIDS patients complicated with opportunistic infection were married male peasants or peasant workers,aged from 41 to 65 years old.The main route of HIV-1 transmission was heterosexual sexual behavior.Bacterial pneumonia was the most frequently found opportunistic infection(50/195,25.6%).The patients were divided into four groups according to CD4^+T lymphocytes count.With the decrease of CD4^+T lymphocytes counts,the numbers of AIDS patients complicated with opportunistic infections increased.The counts of CD8^+T lymphocytes,NK cells,and B lymphocytes decreased as CD4^+T lymphocytes counts decreased.When HIV-1 viral load was high,CD4^+T lymphocytes count was low.When HIV-1 viral load was low,CD4^+T lymphocytes count was high.There was a negative correlation between HIV-1 viral load and CD4^+T lymphocytes count(r=-0.297,P=0.014).Conclusions The clinical manifestations of AIDS patients complicated with opportunistic infection are complex and diverse.The lower the CD4^+T lymphocytes count,the more significant the immune deficiency,the higher the incidence of opportunistic infections.CD4^+T lymphocytes showed a downward trend when HIV-1 viral load increases.Regular monitoring of lymphocytes subsets and HIV-1 viral load in AIDS patients may help predict disease progression,evaluate the efficacy of antiviral treatment,and prevent the occurrence of opportunistic infections.