摘要
目的 分析住院及门诊人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者/获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者(简称HIV感染者/AIDS患者)不同免疫状态下合并巨细胞病毒(human cytomegalovirus,HCMV)感染率情况,进一步了解HIV/AIDS合并HCMV感染的相关影响因素。方法 用流式细胞术进行HIV/AIDS体内CD4T淋巴细胞亚群的计数,采用聚合酶链-荧光法进行HIV/AIDS尿液中HCMV-DNA检测,采用χ检验分析HIV/AIDS不同来源、不同免疫状态下合并HCMV感染率差异。采用Logistic回归分析HIV/AIDS患者合并HCMV感染的相关因素。结果 817例HIV/AIDS患者合并HCMV感染阳性率21.5%(147/817)。HIV/AIDS患者的年龄、性别在是否合并HCMV感染中差异无统计学意义。CD4T细胞≤50个/μL、合并梅毒感染为HIV/AIDS患者合并HCMV感染危险因素(P<0.001,OR=6.410,95%CI=4.141~9.922;P<0.05,OR=1.790,95%CI=1.206~2.657),门诊和住院HIV/AIDS患者合并HCMV感染率差异有统计学意义(χ^(2)=36.042,P<0.001)。以患者来源为分层因素进行CD4T淋巴细胞计数与HCMV感染率分析,住院HIV/AIDS患者CD4T细胞≤50个/μL时为合并HCMV危险因素(P<0.001,OR=4.796,95%CI=2.998~7.668);门诊HIV/AIDS患者,CD4T细胞≤50个/μL时为HIV/AIDS患者合并HCMV危险因素(P<0.001,OR=18.468,95%CI=6.668~51.154)。结论 AIDS期患者应及时筛查有无巨细胞病毒合并感染,AIDS CD4T细胞数≤50个/μL、合并梅毒感染为HIV/AIDS患者合并HCMV感染的危险因素,门诊AIDS患者CD4T细胞≤50个/μL其合并HC-MV感染可能性为CD4T细胞>50个/μL的18.468倍,应予以重视,尽早治疗,获得更好预后。
ObjectiveTo analyze the different immune status of inpatients and outpatients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients (referred to as HIV-infected/AIDS patients) with human cytomegalovirus (HCMV) infection rate,further understand the related factors of HIV/AIDS patients with HCMV infection.MethodsFlow cytometry was used to count the CD4T lymphocyte subsets in HIV/AIDS patients,polymerase chain-fluorescence method was used to detect HCMV-DNA in the urine of HIV/AIDS patients,and the chi-square test was used to analyze the HCMV infection rate in AIDS patients from different sources and different immune states.Logistic regression was used to analyze the related factors of HIV/AIDS patients with HCMV infection.ResultsThe positive rate of817 HIV/AIDS patients with HCMV infection was 21.5%(147/817).The age and gender of HIV/AIDS patients were not statistically different in whether they were combined with HCMV infection.CD4T cells≤50/μL,syphilis infection were risk factors for HIV/AIDS patients with HCMV infection (P<0.001,OR=6.410,95%CI=4.141-9.922;P<0.05,OR=1.790,95%CI=1.206-2.657).There was a statistically significant difference in the HCMV infection rate between outpatient and inpatient HIV/AIDS patients (χ^(2)=36.042,P<0.001).In hospitalized patients,CD4T cells≤50/μL was a risk factor for HIV/AIDS patients with HCMV (P<0.001,OR=4.796,95%CI=2.998-7.668);Outpatient HIV/AIDS patients,CD4T cells≤50/μL was a risk factor for HIV/AIDS patients with HCMV (P<0.001,OR=18.468,95%CCI=6.668-51.154).ConclusionsAIDS patients should be screened for cytomegalovirus infection in time,especially for advanced AIDS CD4T cells≤50/μL,syphilis infection is a risk factor for HIV/AIDS patients with HCMV infection,outpatient AIDS patients CD4T cells≤50/μL,the possibility of combined HCMV infection is 18.468 times that of CD4T cells>50/μL.It should be paid attention to and treated as soon as possible to obtain a better prognosis.
作者
戴同欣
郭蕊
钱宏波
DAI Tong-xin;GUO Rui;QIAN Hong-bo(The Eighth Hospital of Xi'an City,Xi'an,Shaanxi 710061,China)
出处
《中国热带医学》
CAS
2022年第4期355-358,364,共5页
China Tropical Medicine
