艾滋病患者CD4 T细胞计数与机会性感染的关系

The relationship between CD4 T cell count and opportunistic infections in AIDS patients

目的探讨艾滋病(AIDS)患者CD4 T细胞计数与机会性感染的关系。方法选取2015年2月—2017年2月在唐山市传染病医院接受治疗的HIV-1感染的AIDS患者103例,采用流式细胞仪检测CD4 T细胞以及病毒载量,分析其机会性感染发生情况。结果 103例AIDS患者中有90例在住院期间发生机会性感染261例次,感染率为87.38%;口腔假丝酵母菌感染、细菌性肺炎、肺结核发生例次数最多,分别占27.20%、21.46%和16.48%;CD4 T细胞100~200个/μl、50~100个/μl和≤50个/μl的AIDS患者的机会性感染发生率分别为62.96%、81.82%和100.00%,明显高于计数≥200个/μl患者(P<0.05)。CD4 T细胞≤50个/μl的患者口腔假丝酵母感染和细菌性肺炎发生率分别为43.75%和37.50%,明显高于≥200个/μl的患者(P <0.05);CD4 T细胞50~100个/μl的患者细菌性肺炎发生率为13.64%,明显高于≥200个/μl的患者(P <0.05)。不同CD4 T细胞的AIDS患者肺结核、感染性腹泻、卡氏孢子虫肺炎发生率差异无统计学意义(P> 0.05)。CD4 T细胞100~200个/μl、50~100个/μl和≤50个/μl的患者HIV-1病毒载量明显高于CD4 T细胞≥200个/μl的患者(P <0.05)。结论 AIDS患者机会性感染发生率较高,口腔假丝酵母菌感染和细菌性肺炎较常见,且与患者CD4 T细胞计数有一定关系;CD4 T细胞计数与病毒载量有一定关系。

Objective To investigate the relationship between CD4 T cell count and opportunistic infection in AIDS patients.Methods A total of 103 AIDS patients with HIV-1 infection treated in Tangshan Infectious Diseases Hospital from February 2015 to February 2017 were selected,CD4 T cell count and viral load were tested by flow cytometry.The opportunistic infection was analyzed.Results Among 103 AIDScases had 261 opportunistic infections during hospitalization,the infection rate was 87.38%.Candida spp.infection,bacterial pneumonia and pulmonary tuberculosis were the most common cases,accounted for 27.20%and 16.48%.The incidence of opportunistic infection of CD4 T cell in 100-200/μl,50-100/μl and≤50/μl patients was 62.96%and100.00%,which was significantly higher than that of the patients with CD4 T cell≥200/μl(P<0.05).The incidence of oral Candida spp.infection and bacterial pneumonia in patients with CD4 T cell≤50/μl was 43.75%and37.50%,which was significantly higher than that patients with CD4 T cell≥200/μl(P<0.05).The incidence of bacterial pneumonia in patients with 50-100/μl CD4 T cell was 13.64%,which was significantly higher than the patients with≥200/μl CD4 T cell(P<0.05).There was no significant difference in the incidence of pulmonary tuberculosis,infectious diarrhea and sporozoite carinii pneumonia among different CD4 T cell count patients(P>0.05).The HIV-1 viral load of CD4 T cell patients with 100-200/μl,50-100/μl and≤50/μl was significantly higher than that of patients with≥200/μl CD4 T cell(P<0.05).ConclusionThe incidence of opportunistic infections in HIV-1 related AIDS patients was higher,the common infections were oral Candida spp.infection and bacterial pneumonia.The occurrence of opportunistic infections was related to CD4 T cell count,and the number of CD4 T cell was related to viral load of the patients.