HIV/AIDS患者血液及无菌体液中侵袭性真菌感染的分布特征  

Distribution characteristics of invasive fungal infections in blood and sterile body fluids of patients with HIV/AIDS

作　　者：晏国威 李晓琴 胡金伟 伍勇 邬靖敏 YAN Guowei;LI Xiaoqin;HU Jinwei;WU Yong;WU Jingmin(Department of Laboratory Medicine,The First Hospital of Changsha,Changsha 410005,Hunan,China)

机构地区：[1]长沙市第一医院检验科,长沙410005

出　　处：《中国艾滋病性病》2024年第4期361-364,共4页Chinese Journal of Aids & STD

摘　　要：目的 了解长沙地区HIV/AIDS患者血液及无菌体液中侵袭性真菌感染的分布以及不同免疫学特征下侵袭性真菌感染的分布情况。方法 收集2020-2022年在长沙市第一医院艾滋病科住院治疗的414例血液及无菌体液中合并侵袭性真菌感染的HIV/AIDS患者基本信息、真菌类型和标本类型分布以及外周血T淋巴细胞亚群数量进行回顾性分析。结果 414例HIV/AIDS合并侵袭性真菌感染的患者中分离出真菌526株,其中分布前三的真菌分别为马尔尼菲篮状菌380株(72.24%),新型隐球菌120株(22.81%),念珠菌10株(1.90%)。住院期间共361例患者接受了CD4、CD8细胞检测,CD4细胞数≤50个/μL的患者287例(79.50%),CD4/CD8细胞比值≤0.10的患者218例(60.39%),均以合并马尔尼菲篮状菌感染患者为主(85.02%,81.19%)。不同CD4细胞数水平以及不同CD4/CD8细胞比值下三种不同类型的侵袭性真菌感染患者的分布情况,差异有统计学意义(P均<0.01)。结论 HIV/AIDS患者的血液及无菌体液中以马尔尼菲篮状菌和新型隐球菌感染为主。HIV/AIDS患者免疫功能低下时,有较高的马尔尼菲篮状菌感染率。Objective To investigate the distribution of invasive fungal infections in blood and sterile body fluids and the distribution of invasive fungal infections under different immunological characteristics among patients with HIV/AIDS in the Changsha area. Methods Retrospective analysis was performed on the basic information, fungal types,sample types, and T lymphocyte subsets collected from 414 patients with HIV/AIDS having invasive fungal infections in blood and sterile body fluids who were admitted to the First Hospital of Changsha from 2020 to 2022. Results A total of 526 strains of fungi were isolated from 414 patients with HIV/AIDS having invasive fungal infections, among which the top three fungi were Talaromyces marneffei with 380 strains(72.24%), Cryptococcus neoformans with 120 strains(22.81%), and Candida with 10 strains(1.90%). A total of 361 patients underwent CD4, CD8 cell counts during their hospital stay. There were 287 patients(79.50%) with CD4 cell count ≤50/μL and 218 patients(60.39%) with a CD4/CD8cell ratio ≤0.10, both being predominantly infected with T. marneffei(85.02%, 81.19%). The differences in the distribution of patients with three different types of invasive fungal infections were statistically significant under various CD4 cell counts and CD4/CD8 cell ratios(all P<0.01). Conclusions T. marneffei and C. neoformans were the main infections in the blood and sterile body fluids of patients with HIV/AIDS. Patients with HIV/AIDS with low immune function had a higher infection rate of T. marneffei.

关 键 词：艾滋病病毒感染者/艾滋病患者 侵袭性真菌感染 免疫功能 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]