艾滋病合并巨细胞病毒感染的病毒学和血清学特点探讨

The Virology and Serologic Characteristics of HIV Infection with Cytomegalovirus

目的探讨巨细胞病毒(CMV)感染后艾滋病患者的病毒学和血清学特点。方法选取2020年8月至2021年12月于首都医科大学附属北京地坛医院诊治的1004例艾滋病患者,和其中123例艾滋病合并CMV患者,比较在实验室结果方面的差异。结果在标本类型不同中,肺泡灌洗液检测巨细胞病毒核酸结果阳性率高;CD4^(+)T淋巴细胞<50 cells/μL组只在血凝检测方面的FDP显示高于CD4^(+)T淋巴细胞数>50 cells/μL组,其余方面年龄(P=0.001)、T淋巴细胞(P<0.001)、CD8^(+)T淋巴细胞(P<0.001),CD4^(+)T淋巴细胞(P<0.001)、Ratio(P<0.001)、NK细胞(P=0.007)、WBC(P=0.015)、HIV病毒载量(P=0.001),均低于CD4^(+)T淋巴细胞数>50 cells/μL组;EB病毒核酸载量<1.00×10^(3) copies/mL组的CD19^(+)B淋巴细胞112.0(59.0,142.5)高于EB病毒核酸载量>1.00×10^(3) copies/mL组的CD19^(+)B淋巴细胞92.0(27.0,111.0)。结论HIV合并CMV感染患者存在严重的免疫缺陷,及早发现患者的多种感染,加强免疫力,采集有效的标本进行检测,有助于患者病情的康复。

Objective To investigate the virological and serological characteristics of AIDS patients infected with cytomegalovirus(CMV).Methods 1004 AIDS patients diagnosed and treated in Beijing Ditan Hospital affiliated to Capital Medical University from August,2020 to December,2021,and 123 AIDS patients with CMV were selected for the study.We then evaluated the differences in laboratory results between groups.Results The positive rate of cytomegalovirus nucleic acid detected by alveolar lavage fluid was higher in different sample types;For CD4^(+)T lymphocytes,only FDP of group of the lower 50 cells/μL was higher than the group of the higher 50 cells/μL;For other factors,age(P=0.001),T lymphocytes(P<0.001),CD8+T lymphocytes(P<0.001),CD4^(+)T lymphocytes(P<0.001),ratio(P<0.001),NK cells(P=0.007),WBC(P=0.015)and HIV viral load(P=0.001)were lower than the higher 50 cells/μL group;For Epstein-barr virus nucleic acid load in CD19^(+)B cells,the group of the lower 1.00×10^(3) copies/mL 112.0(59.0,142.5)was higher than the group of the higher 1.00×10^(3) copies/mL 92.0(27.0,111.0).Conclusion There are serious immunodeficiency in HIV patients with CMV infection.The early detection of multiple infections in patients,strengthening of immunity and collection of effective specimens for detection are conducive to the recovery of patients.