46例HIV/AIDS患者在高效抗逆转录病毒治疗第一年间口腔念珠菌感染及免疫状况动态变化

Dynamic changes of oral candida infection and immune status of 46 HIV/AIDS patients during the first year of highly active antiretroviral therapy

目的:监测HIV/AIDS患者在高效抗逆转录病毒治疗(HAART)第一年间口腔念珠菌感染及免疫状态变化,并探讨其间的关系。方法:随访46例HIV/AIDS患者,在HAART基线、治疗后3.6、12个月检测患者CD4^(+)T淋巴细胞计数,对患者进行口腔检查并记录口腔念珠菌病发生情况,采集患者口腔含漱液,使用沙保罗琼脂培养基和CHROMagar念珠菌显色培养基进行培养及鉴定。采用SPSS25.0软件包对数据进行统计学分析。结果:HIV/AIDS患者在治疗后3、6、12个月,CD4^(+)T淋巴细胞计数分别为(327.91±138.82)、(329.65±142.66)和(319.98±97.90)个/mm^(3),显著高于基线值的(263.39±126.01)个/mm^(3)(P<0.05);治疗后3.6、12个月,口腔念珠菌病患病率分别为26.09%、21.74%和23.91%,显著低于基线值的52.17%(P<0.05);CD4^(+)T淋巴细胞计数<200个/mm^(3)的患者,口腔念珠菌病患病率显著高于CD4^(+)T淋巴细胞计数≥200个/mm^(3)的患者(P<0.05)。结论:HAART能升高患者CD4^(+)T淋巴细胞计数,使患者免疫得到重建,降低口腔念珠菌病发生率;但CD4^(+)T淋巴细胞计数<200个/mm^(3)的患者,口腔念珠菌病患病率明显增加。

PURPOSE: To monitor oral candida infection and immune status of HIV/AIDS patients during the first year of highly active antiretroviral therapy(HAART), and to explore the relationship between oral candida infection and immune status. METHODS: A total of 46 HIV/AIDS patients were followed up. At baseline, 3, 6 and 12 months after HAART,CD4+T lymphocytes were measured, oral examinations of patients were carried out and the occurrence of oral candidiasis was recorded. Oral rinses were collected, and Sabourd’s dextrose agar and CHROMagar candida medium were used to cul-ture and identify oral candida. Statistical analysis was performed by SPSS 25.0 software package. RESULTS: The counts of CD4+T lymphocytes in HIV/AIDS patients at 3, 6 and 12 months after HAART were(327.91 ±138.82),(329.65±142.66)and(319.98±97.90) cells/mm3, respectively, which were significantly higher than CD4+T lymphocytes(263.39±126.01) at baseline(P <0.05). The prevalence of oral candidiasis at 3, 6 and 12 months after HAART was 26.09%, 21.74% and23.91%, respectively, which was significantly lower than that(52.17%) at baseline(P<0.05). The prevalence of oral candidiasis in patients with CD4+T lymphocyte <200 cells/mm3 was significantly higher than that in patients with CD4+T lymphocyte ≥200 cells/mm3(P<0.05). CONCLUSIONS: HAART can increase CD4+T lymphocytes, reconstruct the immunity of patients and reduce the incidence of oral candidiasis, but the incidence of oral candidiasis significantly increased in patients with CD4+T lymphocyte <200 cells/mm3.