HIV/AIDS病人合并梅毒感染及其对免疫功能的影响

Infection status and CD4^+T lymphocyte results of syphilis and HIV co-infection

目的了解艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)合并梅毒感染的流行情况及对免疫功能的影响,为艾滋病的防治提供参考依据。方法收集2014-2018年湖州市新发现1205例HIV/AIDS病人基本信息、采用酶联免疫吸附试验(ELISA)和梅毒甲苯胺红不加热血清试验(TRUST)检测梅毒抗体,以及配合检测首次随访CD4+T淋巴细胞(简称CD4细胞)898例,并统计分析不同人群的合并梅毒感染率、CD4细胞计数结果。结果2014-2018年湖州市HIV/AIDS病人共1205例,合并梅毒感染率为15.27%(184例),农村居民20.39%(155/760),城市居民6.52%(29/445)(P<0.01);离异/丧偶者29.89%(107/358),未婚6.17%(19例)和已婚10.76%(58例)(P<0.01);性传播人群16.40%(176/1073),其他人群6.06%(8/132)(P<0.01);CD4细胞≤200个/μL的HIV/AIDS病人合并梅毒感染(34.86%)高于≥351个/μL的合并梅毒感染率(7.82%)(P<0.01);1205例HIV/AIDS病人性行为感染率与合并梅毒感染率存在显著性正相关(R=0.980,P<0.05)。结论梅毒能提高HIV感染的风险,应定时监测和及时治疗,并在预防控制艾滋病的同时还应采取预防梅毒感染措施,联合开展艾滋病合并梅毒感染的预防和控制工作。

Objective To understand the prevalence of HIV/AIDS patients with syphilis infection and its impact on immune function,and provide reference for AIDS prevention and treatment.Methods Basic information of 1205 newly diagnosed HIV/AIDS patients were collected in Huzhou from 2014 to 2018,and ELISA and TRUST were used to detect syphilis antibodies.898 cases of CD4^+T lymphocytes were followed up for the first time after HIV was diagnosed.The infection rate,and CD4^+T lymphocyte count results of different groups were analyzed accordingly.Results A total of 1205 HIV-infected/AIDS patients were reported in Huzhou from 2014 to 2018.The co-infection rate of syphilis/HIV was 15.27%(184 cases),with 20.39%(155 cases)of rural residents,higher than 6.52%(29 cases)of the urban residents(P<0.05),29.89%(107 cases)of divorced/widowed,higher than 6.17%(19 cases)unmarried and 10.76%(58 cases)married(P<0.05),and 16.40%(176 cases)of sexually transmitted,higher than 6.06%(8 cases)of other people(P<0.05).CD4^+T lymphocytes≤200/μl of HIV/AIDS patients with syphilis infection(34.86%)was higher than those≥351/μl of HIV/AIDS cases with syphilis infection(7.82%)(P<0.05).There was significant positive correlation between the sexual contact infection rate and syphilis infection rate in 1205 HIV/AIDS patients(R=0.980,P<0.05).Conclusion Syphilis can increase the risk of HIV infection.It should be regularly monitored and timely treated.While preventing and controlling AIDS,we should also take measures to prevent syphilis infection.