梅毒螺旋体对HIV感染初治患者HIV RNA水平与T细胞计数的影响  

Effect of Treponema pallidum on HIV RNA and T cell counts in HIV-primarily treated patients

作　　者：尹白露 程娟 姜天俊 杨宝鹏 王福生 YIN Bailu;CHENG Juan;JIANG Tianjun;YANG Baopeng;WANG Fusheng(Graduate School of Bengbu Medical University,233030,China;National Clinical Research Center for Infectious Diseases,Department of Infectious Diseases,Fifth Medical Center,PLA General Hospital,Beijing 100039,China)

机构地区：[1]蚌埠医科大学研究生院,2330303 [2]解放军总医院第五医学中心感染病医学部、国家感染性疾病临床研究中心,北京100039

出　　处：《传染病信息》2024年第2期113-118,共6页Infectious Disease Information

基　　金：深圳市“医疗卫生三名工程”项目(2017A45)。

摘　　要：目的本研究拟探索梅毒螺旋体(Treponema pallidum,TP)对人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染初治患者HIV RNA与T细胞计数的影响,HIV感染初治患者基线CD4^(+)T低于最低正常值范围的影响因素。为临床诊断中为TP合并HIV感染者确定合适的ART与梅毒治疗方案提供参考。方法本研究纳入我院爱心门诊收治的HIV感染初治患者106例,其中TP合并HIV感染者51例(合并感染组)、单纯HIV感染者56例(单纯感染组),准确记录血常规、生化、T细胞数值、HIV RNA等变量;根据2022年中国梅毒诊疗指南与2021中国艾滋病诊疗指南制定纳入排除标准,使用卡方检验、Mann-Whitney检验、二元Logistic回归分析TP对HIV感染初治患者基线HIV RNA水平、T淋巴细胞以及生化定量指标的影响、及HIV初治患者CD4^(+)T低于最低正常值范围的影响因素。结果合并感染组与单纯感染组HIV初治患者相比,T淋巴细胞计数(CD4^(+)、CD3^(+)、CD8^(+)标记)、CD4^(+)/CD8^(+)以及HIV RNA水平差异无统计学意义(P均>0.05)。白细胞计数、婚姻状况(离异或分居)作为独立保护因素促进HIV初治患者基线CD4^(+)T淋巴细胞数值高于最低正常值范围,无危险因素。结论合并梅毒不会影响HIV感染初治患者HIV RNA与T淋巴细胞数值,但白细胞计数与婚姻状况(离异)是影响CD4^(+)T淋巴细胞数值的独立影响因素。Objective This study intends to explore the effect of Treponema pallidum(TP)on HIV RNA and T cell counts in HIV primed patients,and the factors influencing baseline CD4^(+)T below the lowest normal range in HIV primed patients.To provide a reference for determining the appropriate ART and syphilis treatment regimen for TP co-infected HIV patients in clinical diagnosis.Methods The present study included 106 cases of primary HIV infected patients admitted to our compassionate outpatient clinic,including 51 cases of TP co-infected with HIV(co-infected group)and 56 cases of HIV infected alone(simple infected group),with accurate recording of variables such as blood counts,biochemistry,T cell values,HIV RNA,and so on;The inclusion and exclusion criteria were established according to the 2022 Chinese Syphilis Guidelines and the 2021 Chinese AIDS Guidelines,and the effects of TP on baseline HIV RNA levels,T lymphocytes,and quantitative biochemical indexes in patients with primary HIV treatment,and the effect of CD4^(+)T below the minimum normal range in patients with primary HIV treatment were analysed using chi-square test,Mann-Whitney test,and binary logistic regression.range of normal values.Results The differences in T-lymphocyte counts(CD4^(+),CD3^(+),and CD8^(+) markers),CD4^(+)/CD8^(+),and HIV RNA levels were not statistically significant in the co-infected group compared to the HIV primary patients in the infected-only group(P>0.05).Leukocyte count and marital status(divorced or separated)as independent protective factors promoted baseline CD4^(+)T lymphocyte values above the lowest normal range in HIV primaries with no risk factors.Conclusion Comorbid syphilis does not affect HIV RNA and T lymphocyte values in HIV primaries,but leukocyte count and marital status(divorced or separated)are Independent influencing factors that affect CD4^(+)T-lymphocyte values.

关 键 词：梅毒 人类免疫缺陷病毒 人类免疫缺陷病毒RNA CD4^(+)T淋巴细胞 

分 类 号：R587.2[医药卫生—内分泌] R521[医药卫生—内科学]