HIV/AIDS病人外周血中EBV DNA检测与艾滋病相关淋巴瘤的情况分析

Analysis of EBV DNA detection and AIDS related lymphoma in HIV/AIDS patients

目的探讨艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)外周血EB病毒(EBV)脱氧核糖核酸(DAN)载量对艾滋病相关淋巴瘤的预测价值。方法收集2016年1月至2019年5月期间,在本院进行EBV DNA载量检测的HIV/AIDS病人资料。通过SPSS统计软件进行分析,用交叉表进行风险估计,并以比值比(OR)表示。对HIV/AIDS病人合并淋巴瘤的情况进行分析。结果共收集481例检测EBV DAN载量的HIV/ADIS病人,男性352例(73.2%),女性129例(26.8%)。EBV DNA>1000拷贝/mL的患者299例,阳性率62.2%。EB病毒感染组CD4+T淋巴细胞(简称CD4细胞)计数低于非感染组(P<0.05);合并淋巴瘤的患者占10.6%(51/481);EBV DNA(+)淋巴瘤的患病率为14.4%(43/299),EBV DNA(-)淋巴瘤的患病率为4.4%(8/182),两组之间差异有统计学意义(P=0.01)。在合并的淋巴瘤类型中,弥漫大B细胞淋巴瘤占80.4%(41/51),伯基特淋巴瘤和霍奇金淋巴瘤均占7.8%(4/51)。弥漫大B细胞淋巴瘤CD4细胞平均值为(156±116.88)个/μL,伯基特淋巴瘤CD4细胞平均值为(282±70)个/μL,两者间差异有统计学意义(t=-2.106,P=0.026),霍奇金淋巴瘤CD4细胞平均值(213±152)个/μL,浆母细胞淋巴瘤CD4细胞为126个/μL。EBV DNA载量数量级从10^3至10^5其淋巴瘤的患病率从8.4%上升至24.44%。不同EBV DNA数量级的患者,淋巴瘤患病风险分别为:10^3[比值比(OR)=2.00,95%可信区间(CI):0.76~5.21],104(OR=3.06,95%CI:1.58~5.92),105(OR=3.20,95%CI:1.51~6.81)。结论在HIV/AIDS病人中,外周血EBV DNA载量>1000拷贝/mL的病人与EBV DNA载量<1000拷贝/mL病人相比,其淋巴瘤患病风险增加至少2倍,且随着EBV DNA载量数量级的增加患淋巴瘤的风险随之增加。

Objective To explore the predictive value of EBV detection in HIV/AIDS patients’blood for AIDS related lymphoma.Methods The data of HIV/AIDS patients who had EBV DNA load test in our hospital from January 2016 to May 2019 were collected.SPSS statistical software was used to analyze the risk and the cross table was used for risk estimation.The cases of HIV/AIDS patients with lymphoma were analyzed.Results There was a total of 481 HIV/ADIS patients,with 352(73.2%)male and 129(26.8%)female.The positive rate of EBV DNA was 62.2%.The number of CD4+T lymphocytes in EBV infected group was lower than that in non infected group(P<0.05).The patients with lymphoma accounted for 10.6%(51/481).The prevalence of EBV DNA(+)lymphoma was 14.4%(43/299),and the prevalence of EBV DNA(-)lymphoma was 4.4%(8/182),with the difference between the two groups statistically significant(P=0.01).Diffuse large B-cell lymphoma accounted for 80.4%(41/51),and Burkitt’s lymphoma and Hodgkin’s lymphoma for 7.8%(4/51).The mean value of CD4 cells was(156±116.88)in diffuse large B-cell lymphoma and(282±70)in Burkitt’s lymphoma(t=-2.106,P=0.026).The mean value of CD4 cells was(213±152)in Hodgkin’s lymphoma and 126/μL in plasma mother cell lymphoma.The prevalence of EBV lymphoma increased from 8.4%to 24.44%from 103 to 105.The risk of lymphoma was 103(or=2.00,95%CI:0.76-5.21),104(or=3.06,95%CI:1.58-5.92),and 105(or=3.20,95%CI:1.51-6.81).Conclusion The HIV/AIDS patients with EBV DNA load>1000 copies/ml in the peripheral blood have at least two times higher risk of lymphoma than those with EBV DNA load<1000 copies/ml,and the risk of lymphoma increases with the increase of EBV DNA load.