摘要
目的调查HIV/AIDS患者中巨细胞病毒(CMV)感染情况,比较血抗-CMV-IgM、血或尿CMV DNA载量等实验室指标以判断CMV感染的阳性检出率。方法采用化学发光免疫分析法(CLIA)和荧光定量PCR(FQ-PCR)方法分别检测HIV/AIDS患者的血抗-CMV-IgM、血/尿CMV DNA载量;同时计数外周血CD4+T淋巴细胞,收集患者高效高效抗逆转录病毒治疗(HAART)情况。结果 431例HIV/AIDS患者中,共检出CMV DNA阳性者148例,阳性率为34.34%。合并CMV感染的HIV/AIDS患者CD4+T细胞计数显著低于非CMV感染者,其差异具有统计学意义(χ2=62.14,P<0.0001),而HIV RNA载量则呈相反趋势(χ2=128.39,P<0.0001)。非CMV感染者中,正在接受HAART治疗的患者比例(240/283,84.81%)显著高于CMV感染者(50/148,33.78%)(χ2=114.93,P<0.0001)。依据血抗-CMV-IgM、血/尿CMV DNA载量等实验室指标判断CMV感染的检测情况来看,尿CMV DNA阳性检出率为90.54%(134/148),显著高于其他两种指标。此外,HIV合并CMV感染者的临床表现并不明显,眼部疾病及眼底改变为其主要症状。结论 HIV感染是否合并CMV感染与HIV/AIDS患者的免疫状态及是否接受HAART治疗相关。应在HIV/AIDS患者中检测尿CMV DNA载量来确定有无CMV感染,同时常规行眼底检查,以期提高CMV感染的早期检出率。
Objective To investigate on the clinical characteristics of HIV/AIDS patients with cytomegalovirus infection. The percentage of cytomegalovirus infection was determined by different laboratory parameters including blood anti-CMV-IgM and blood/urine CMV DNA. Methods The quantity of blood anti-CMV-IgM and blood/urine CMV DNA were detected by CILA and FQ-PCR. The number of CD4＋ T cells and HIV RNA in peripheral blood were also simultaneously determined to evaluate the efficiency of HARRT. Results There were 148 positive cytomegalovirus carriers among 431 HIV/AIDS patients. The percentage of cytomegalovirus infection was 34.34%. The number of CD4＋ T cells of HIV/ AIDS patients with co-infection of cytomegalovirus was lower than that of patients with HIV but without CMV infection. The statistical results showed significant difference （x2= 62.14, P 〈 0.0001）. By contrast, the percentage of HIV RNA load of AIDS patients without cytomegalovirus infection who were treated by HAART was significantly higher than that of those with both HIV and cytomegalovirus infection （84.81% vs 33.78%） （x2= 114.93, P 〈 0.0001）. The results of CMV infection shown by blood anti-CMV-IgM and blood/urine CMV DNA indicated that the positive percentage of urine CMV DNA was the highest rate （90.54%） of detecting cytomegalovirus infection among those of blood anti-CMV-IgM and blood/urine CMV DNA. In addition, the clinical features of patients with both HIV and cytomegalovirus infection were not significantly different. Eye diseases and fundus changes were the major symptoms. Conclusions Whether people with HIV infection are co-infected by CMV or not is related to the immune status of AIDS patients and dependent on HAART therapy. The urine CMV DNA should be conducted to detect the cytomegalovirus infection and the routine fundus examination should also be carried out so that the possibility of detection of cytomegalovirus infection could be improved at early stage of CMV infection in AIDS patients.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2013年第2期39-43,共5页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
深圳市新发传染病重点专科项目(No.2011-61)
关键词
人类免疫缺陷病毒
获得性免疫缺陷综合征
巨细胞病毒
Human immunodeficiency virus （HIV）
Acquired immune deficiency syndrome（AIDS）
Cytomegalovirus
