HIV/AIDS患者机会性感染与CD4+ T淋巴细胞间的关联性

目的 研究人免疫缺陷病毒（HIV）感染者及艾滋病（AIDS）患者发生机会性感染的概率与自身CD4+ T淋巴细胞之间的关系，为HIV患者机会性感染的防治提供参考。方法 以2016年6月至2017年6月我院400例HIV患者为研究对象，回顾性分析不同CD4+T淋巴细胞计数HIV患者发生机会性感染的情况。结果 400例HIV患者发生机会性感染178例，总感染率为44.5%。CD4+T淋巴细胞计数≤50个/μL的患者机会性感染发生率（86.67%）最高，与其他各组比较差异有统计学意义（P<0.05）。随着CD4+ T淋巴细胞计数的减少，HIV患者机会性感染率升高。178例机会性感染者中，单一感染82例，2部位感染52例，3部位感染28例，4部位以上感染16例。感染病原体检测显示，细菌感染84例（47.19%），结核杆菌感染36例（20.22%），病毒感染30例（16.85%，包括巨细胞病毒感染18例、单纯疱疹病毒感染12例），真菌感染77例（43.25%，包括假丝酵母感染35例，肺孢子菌感染20例，马尔尼菲青霉菌感染12例，新型隐球菌感染10例），未明确病原体性质34例（19.10%），复合感染多见。结论 CD4+ T淋巴细胞水平与HIV患者继发机会性感染的概率关系密切。HIV患者CD4+ T淋巴细胞水平的监测对其继发机会性感染的防控具有重要临床意义。

The correlation between opportunistic infection and CD4+ T lymphocytes in HIV/AIDS patients

Objective To explore the correlation between opportunistic infection and CD4+ T lymphocytes in patients with HIV infection or acquired immunodeficiency syndrome (AIDS) and provide reference for the prevention and treatment of opportunistic infections in HIV patients. Methods 400 HIV infected patients in our hospital from June 2016 to June 2017 were selected as the subjects. The incidences of opportunistic infections in HIV patients with different CD4+ T lymphocyte counts were analyzed retrospectively. Results There were 178 cases of opportunistic infections in the 400 HIV patients; the overall infection rate was 44.5%. The incidence of opportunistic infections in the patients with CD4+ T lymphocyte count ≤50/μL was the highest, reaching up to 86.67%, significantly higher than the other groups (Ps<0.05). With the decrease of CD4+ T lymphocyte count, the incidence of opportunistic infections in HIV patients increased. In the 178 cases of opportunistic infections, 82 cases were single infections, 52 cases were double site infections, 28 cases were triple site infections, and 16 cases were multiple (more than four sites) infections. The pathogen detection showed that 84 cases were bacterium infection (47.19%), 36 cases were Tuberculosis bacilli infection (20.22%), 30 cases were virus infection (16.85%, including 18 cases of cytomegalovirus infections and 12 cases of herpes simplex virus infections), 77 cases were fungal infection (43.25%, including 35 cases of Candida infection, 20 cases of Pneumocystis infections, 12 cases of Penicillium marneffy infection, and 10 cases of Cryptococcus neoformans infection), and 34 cases (19.10%) were unidentified pathogen infections. Complex infections were common. Conclusion The level of CD4+ T lymphocytes was closely related to the probability of secondary opportunistic infections in HIV infected patients. The monitoring on the CD4+ T lymphocyte level in HIV infected patients has important clinical significance for the prevention of secondary opportunistic infections.