HIV/AIDS患者合并感染机会性致病原虫与CD4^(+)T淋巴细胞数的相关性  

Correlation between opportunistic infection of pathogenic protozoa and CD4T lymphocyte count in HIV/AIDS

作　　者：褚文达 唐海丰 张雨沁 杨兴堂[1] 崔世勇[1] 张月娟[1] 张正琪 唐小德 CHU Wen-da;TANG Hai-feng;ZHANG Yu-qin;YANG Xing-tang;CUI Shi-yong;ZHANG Yue-juan;ZHANG Zheng-qi;TANG Xiao-de(Baoshan District Center for Disease Control and Prevention of Shanghai,Shanghai 201901;Putuo District Center for Disease Control and Prevention of Shanghai,Shanghai 200333,China)

机构地区：[1]上海市宝山区疾病预防控制中心微生物检验科 [2]上海市普陀区疾病预防控制中心微生物检验科

出　　处：《热带医学杂志》2021年第3期352-355,共4页Journal of Tropical Medicine

基　　金：上海市宝山区卫生青年医学人才培养计划资助(bswsyq-2017-A24);上海市宝山区科学技术委员会(17-E-41)。

摘　　要：目的调查HIV/AIDS患者合并感染机会性致病原虫的情况并分析其与CD4+T淋巴细胞数的相关性。方法对1033份完成CD4+T淋巴细胞计数的HIV/AIDS患者血清进行弓形虫、隐孢子虫和蓝氏贾第鞭毛虫IgG抗体检测,结合患者人口学特征和CD4+T淋巴细胞计数结果进行统计分析。结果共有213人(20.5%)感染机会性致病原虫,其中感染弓形虫45人(4.4%),感染隐孢子虫101人(9.8%),感染蓝氏贾第鞭毛虫77人(7.5%),有10人同时感染两种原虫,未发现同时感染三种原虫的患者。男女患者感染三种原虫的比例差异无统计学意义(P>0.05)。不同年龄段患者的弓形虫感染率差异无统计学意义(P>0.05),但是感染隐孢子虫和蓝氏贾第鞭毛虫的差异有统计学意义(P<0.05)。维族患者感染弓形虫的比例明显高于汉族患者(P<0.05),达到了37.50%。因注射吸毒而感染HIV的患者感染弓形虫的比例明显高于同性传播和异性传播而感染HIV的患者。CD4+T淋巴细胞数<500个/μL的免疫缺陷组感染弓形虫的比例明显高于CD4+T淋巴细胞数≥500个/μL的无免疫缺陷组,差异有统计学意义(P<0.05),而感染隐孢子虫和蓝氏贾第鞭毛虫的差异无统计学意义(P>0.05)。结论CD4+T淋巴细胞数<500个/μL和注射吸毒会增加HIV/AIDS患者感染弓形虫的风险,但是对隐孢子虫和蓝氏贾第鞭毛虫的感染率无明显影响。Objective To investigate the opportunistic infection of pathogenic protozoa in HIV/AIDS and analyze its correlation with CD4+T lymphocyte count.Method A total of 1033 HIV/AIDS sera with CD4+T lymphocyte count were tested for IgG antibodies to Toxoplasma gondii,Cryptosporidium hominis and Giardia lamblia,and statistical analysis was conducted by combing demographic characteristics and CD4+T lymphocyte count results.Results A total of 213(20.5%)cases were infected with opportunistic pathogens,including 45(4.4%)cases with T.gondii,101(9.8%)cases with C.hominis,and 77(7.5%)cases with G.lamblia.10 cases were infected with two protozoa concurrently and none was found to be infected with three protozoa concurrently.There was no significant difference in the proportion of patients infected with the three protozoa between male and female(P>0.05).The proportion of patients infected with T.gondii was not significantly different in different age groups(P>0.05);the infection rates of C.hominis and G.lamblia were different in different age groups(P<0.05).The proportion of Uyghur patients infected with T.gondii reaching 37.50%,and was significantly higher than that of Han patients(P<0.05).The proportion of HIV patients infected through drug injection was significantly higher than that from homosexual and heterosexual transmission.The proportion of patients infected with T.gondii in the immunodeficiency group(CD4+T lymphocytes<500/μL)was significantly higher than that of the non-immunodeficiency group(CD4+T lymphocytes≥500/μL)(P<0.05),and there was no significant difference in the proportion of Chominis and G.lamblia(P>0.05).Conclusion CD4+T lymphocytes less than 500/μL and with drug injection could increase the risk of HIV/AIDS infection with T.gondii,but had no significant effect on the infection rate of C.hominis and G.lamblia.

关 键 词：艾滋病 弓形虫 隐孢子虫 蓝氏贾第鞭毛虫 CD4 

分 类 号：R512.91[医药卫生—内科学]