HIV感染合并肝炎患者病毒载量及其与T淋巴细胞计数的关系  

Viral load of HIV infection with hepatitis and the relationship between baseline viral load and T lymphocytes count

作　　者：李虎 冯疆涛 许铭玉 董伟 麦尔哈巴·木塔力甫 罗文伟 LI Hu;FENG Jiangtao;XU Mingyu;DONG Wei;Maierhaba MUTALIFU;LUO Wenwei(Aksu Regional Centre for Disease Control and Prevention,Aksu,Xinjiang 843000,China)

机构地区：[1]阿克苏地区疾病预防控制中心,新疆阿克苏843000

出　　处：《中国国境卫生检疫杂志》2025年第1期65-69,共5页Chinese Journal of Frontier Health and Quarantine

基　　金：新疆维吾尔自治区自然科学基金项目(2021D01C225)。

摘　　要：目的分析人类免疫缺陷病毒(HIV)感染合并肝炎患者的基线病毒载量,并观察影响因素以及T淋巴细胞与基线病毒载量的关系。方法回顾性分析新疆阿克苏地区疾病预防控制中心2021年1月—2023年12月收集的685例HIV感染者资料,根据是否合并肝炎分为合并组(322例)和无合并组(363例),检测所有患者基线HIV病毒载量及T淋巴细胞亚群水平;比较合并组与无合并组患者基线HIV病毒载量及T淋巴细胞亚群水平,分析合并组HIV病毒载量与淋巴细胞亚群关系。根据HIV合并肝炎患者的HIV病毒载量将其分为基线高病毒载量(≥10~5拷贝/ml)组(107例)和基线低病毒载量(<10~5拷贝/ml)组(215例),单因素和多因素分析HIV合并肝炎患者HIV病毒载量的影响因素。结果两组患者的性别、年龄、感染时间、感染途径、HIV感染分期、文化程度差异均无统计学意义(P>0.05)。合并组HIV病毒载量[(5.28±1.06)]高于无合并组[(4.21±0.84)],CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)T淋巴细胞[(1152.46±384.15)、(185.24±61.75)、(657.88±219.29)、(0.28±0.09)]均低于无合并组(P<0.05)。合并组患者的CD4^(+)、CD4^(+)/CD8^(+)T淋巴细胞水平与HIV病毒载量呈负相关(r=-0.435、-0.685,P=0.018),CD3^(+)、CD8^(+)T淋巴细胞水平与HIV病毒载量无显著相关性(P>0.05)。单因素分析显示,基线高病毒载量患者男性、年龄≥50岁、性传播、文化程度为初中及以下占比[(70.09%)、(41.12%)、(79.44%)、(54.21%)]均高于基线低病毒载量患者(P<0.05)。二元Logistic回归分析显示,性别(OR=2.684,95%CI:1.137~6.333)、年龄(OR=3.492,95%CI:1.610~7.574)、感染途径(OR=6.077,95%CI:2.197~16.806)是HIV合并肝炎患者基线高病毒载量的独立危险因素,CD4^(+)(OR=0.196,95%CI:0.101~0.378)、CD4^(+)/CD8^(+)(OR=0.211,95%CI:0.089~0.501)水平是独立保护因素(P<0.05)。结论HIV合并肝炎患者的基线HIV病毒载量显著升高,且CD4^(+)、CD4^(+)/CD8^(+)水平与患者HIV病毒�Objective To analyze the baseline viral load in human immunodeficiency virus(HIV)infection with hepatitis,observe the influencing factors and the relationship between T lymphocytes and baseline viral load.Methods The data of 685HIV infected patients recorded in Akesu Center for Disease Control and Prevention in Xinjiang from January 2021 to December 2023 were retrospectively analyzed.According to whether they were complicated with hepatitis,they were divided into the combined group(322 cases)and the non-combined group(363 cases).The baseline HIV viral load and T lymphocyte subgroup levels were compared.The relationship between HIV viral load and T lymphocyte subgroup in the combined group was analyzed.According to HIV viral load,the patients were divided into the high baseline viral load group(≥10~5copies/ml,107 cases)and low baseline viral load group(<10~5copies/ml,215 cases).Univariate and multivariate analyses were used to analyze the influencing factors of HIV viral load in patients with HIV and hepatitis.Results There was no significant difference in gender,age,infection time,infection route,HIV infection stage and education level between the two groups(P>0.05).The HIV viral load of the combined group[(5.28±1.06)]was higher than that of non-combined group[(4.21±0.84)].CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)T lymphocytes count[(1152.46±384.15),(185.24±61.75),(657.88±219.29),(0.28±0.09)]in the combined group were lower than those in non-combined group(P<0.05).The levels of CD4^(+)and CD4^(+)/CD8^(+)T lymphocytes were negatively correlated with HIV viral load(r=-0.435,-0.685,P=0.018),while the levels of CD3^(+)and CD8^(+)T lymphocytes were not significantly correlated with HIV viral load(P>0.05).Univariate analysis showed that the proportion of male with high viral load at baseline,the proportion of age≥50 years old,the proportion of sexual transmission,the proportion of education level of middle school or below[(70.09%),(41.12%),(79.44%),(54.21%)]were higher than those of patients with low viral load

关 键 词：人类免疫缺陷病毒 肝炎 病毒载量 T淋巴细胞 

分 类 号：R512.6[医药卫生—内科学] R512.911[医药卫生—临床医学]