不同CD4^+水平HIV阳性患者抗病毒治疗的机会性感染分析  

Opportunistic infection and mortality rate in HIV-infected patients with different CD4^+ T cells after 1 year antiviral treatment

作　　者：丁佩佩[1] 何纲[1] 陈晓华[1] 甄沛林[1] 吴兴柳[1] 李志杰[2] 黄劲华 

机构地区：[1]江门市中心医院感染科,广东江门529030 [2]江门市新会区人民医院感染科,广东江门529100 [3]台山市人民医院感染科,广东江门529200

出　　处：《中国热带医学》2016年第3期252-254,共3页China Tropical Medicine

基　　金：广东省产业技术研究与开发资金计划项目(No.2012A030400030)

摘　　要：目的对不同CD4^+T淋巴细胞(简称CD4^+细胞)成人HIV阳性患者启动ART(抗逆转录病毒治疗)1年过程中发生的机会性感染及病死率进行分析,探讨最佳治疗时机以指导治疗。方法 179例HIV感染者分为A组(CD4^+≥350/μL),B组(200/μL≤CD4^+<350/μL),C组(CD4^+<200/μL)三组。使用ART治疗,观察时间为1年,比较各组患者治疗开始前及治疗过程中发生的机会性感染及治疗过程中的病死率。结果三组间机会性感染发生率:C组最高(62.50%),A组最低(6.52%),B组为(32.79%),差异有统计学意义(P<0.05)。结核菌感染C组(15.28%),高于A组(2.17%),差异有统计学意义(P<0.05)。真菌感染则C组(36.11%)高于B组(8.20%),差异有统计学意义(P<0.05)。结论早期启动ART治疗可以预防HIV感染者机会性感染的发生,降低病死率。对于CD4^+细胞数较低的患者,ART治疗的前3个月仍需要密切观察病情变化及机会性感染的发生,降低病死率。Objective To analyze opportunistic infection and mortality rate in HIV-infected patients with different CD4^＋T cells after 1 year antiviral therapy（ART） to identity the optimal timing for ART initiation. Methods A total of 179 HIV-infected patients were divided into group A（CD4^＋≥350/μL）,group B（200/μL≤CD4^＋〈350/μL） and group C（CD4^＋〈200/μL）.Rates of opportunistic infection and mortality were compared among study groups before and after 1 year of ART. Results The rate of opportunistic infection significantly differed among the three groups [group C（62.50%）〉group B（32.79%）〉groupA（6.52%）, P 〈0.05 respectively]. The rate of tuberculosis infection was significantly higher in group C（15.28%） than in groupA（2.17%）（P 〈0.05）. Fungal infection rate in group C（36.11%） was significantly higher than in group B（8.20%）（P 〈0.05）.Conclusion Early treatment is beneficial in reducing rates of opportunistic infection and mortality. Close attention foropportunistic infection should be paid to patients who have low levels of CD4^＋cells when ART is initiated in order to reduce themortality rate.

关 键 词：HIV CD4^+T细胞计数 抗逆转录病毒治疗 机会性感染 病死率 

分 类 号：R512.91[医药卫生—内科学]