广西免疫重建不良的人类免疫缺陷病毒感染者发生机会性感染的特点

doi:10.3969/j.issn.1006-5725.2023.23.010

Abstract

Abstract:

Objective To explore the characteristics of opportunistic infections （OIs） in HIV?infected individuals with suboptimal immune reconstitution after ART treatment so as to provide a reference for preventing and managing HIV infections. Methods The clinical data including opportunistic infections specifically were acquired from 112 HIV?infected individuals with suboptimal immune reconstitution from the outpatient department of Wuming Hospital， Guangxi Medical University. The impact of baseline CD4⁺T lymphocyte counts on the incidence， type， and mixed infection rates of the opportunistic infections were analyzed. Results The opportunistic infection rate among the 112 HIV?infected individuals with suboptimal immune reconstitution was 42.86%， among which fungal infections were the most commonly seen. The opportunistic infection rate of the patients with a baseline of CD4⁺T lymphocyte counts ≤ 50/μL was significantly higher than that of the patients with a baseline of CD4⁺T lymphocyte counts > 50/μL， and there was no significant difference in the type of opportunistic infections as well as the rate of mixed infections. Conclusion HIV?infected people with suboptimal immune reconstitution in Guangxi are susceptible to HIV OIs. Among them， the group with a baseline CD4⁺ T lymphocyte counts ≤ 50/μL has a higher rate of OIs， mainly fungal infections.

Key words: HIV, opportunistic infections, suboptimal immune reconstruction, antiretroviral therapy

CLC Number:

R512.91

Lei JI,Tiantian LI,Jianlin WU,Xianli XU,Chunlan ZHANG,Xiaojie LAO,Xinyin MEI,Yangni LU,Maowei. CHEN. Characteristics of opportunistic infections in HIV⁃infected individuals with suboptimal immune reconstruction in Guangxi[J]. The Journal of Practical Medicine, 2023, 39(23): 3082-3086.

Figures/Tables 6

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References 26

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特征	例数	构成比（%）
性别
男	81	72.32
女	31	27.68
年龄
30 ~ 44岁	31	27.68
45 ~ 59岁	40	35.71
≥ 60岁	41	36.61
文化程度
小学及以下	40	35.71
初中及中专	60	53.57
高中以上	12	10.72
职业
农民	95	84.82
其他	17	15.18
婚姻状况
已婚	79	70.54
未婚	19	16.96
离异或丧偶	14	12.50
感染途径
性接触	108	96.42
其他方式	4	3.58
治疗时长
≥ 1年但 < 3年	32	28.57
≥ 3年但 < 5年	13	11.61
5年及以上	67	59.82
基线CD4⁺T淋巴细胞计数
≤ 50个/μL	49	43.75
51 ~ 100个/μL	21	18.75
101 ~ 200个/μL	29	25.89
> 200个/μL	13	11.61
基线CD8⁺T淋巴细胞计数
≤ 500个/μL	38	33.93
501 ~ 1 000个/μL	45	40.18
> 1 000个/μL	29	25.89
基线CD4/CD8比值
< 0.1	62	55.35
0.1～	21	18.75
0.2～	14	12.50
0.3～	8	7.14
0.4～	5	4.46
≥ 0.5	2	1.79
初始治疗方案
3TC + EFV + TDF	50	44.65
AZT + 3TC + NVP	32	28.57
AZT + 3TC + EFV	16	14.28
其他	14	12.50

免疫重建不良累计持续时间	机会性感染	无机会性感染
< 1年	9	12
1 ~ 2年	14	28
> 2年	25	24
χ ² 值	2.89
P值	0.24

基线CD4⁺T淋巴细胞计数	机会性感染	无机会性感染
≤ 50/μL	33（67.35）	16（32.65）
> 50/μL	15（23.81）	48（76.19）
χ ² 值	21.33
P值	< 0.01

基线CD4⁺T淋巴细胞计数	真菌	细菌	疱疹病毒	结核分枝杆菌	PCP	其他	1种感染	混合感染
≤ 50 μL	26	3	5	3	11	6	20	13
> 50 μL	5	2	6	3	4	1	12	3
F/χ ² 值	8.35						1.75
P值	0.11						0.19

预后情况	例数	构成比（%）
机会性感染	48	42.86
无机会性感染	64	57.14

Characteristics of opportunistic infections in HIV⁃infected individuals with suboptimal immune reconstruction in Guangxi

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机会性感染类型	例数	构成比（%）
鹅口疮	23	30.68
PCP	15	20.00
带状疱疹	10	13.33
马尔尼菲蓝状菌	6	8.00
肺结核	5	6.67
细菌性肺炎	5	6.67
弓形虫脑病	1	1.33
慢性带状疱疹	1	1.33
真菌性肺炎	1	1.33
食道真菌病	1	1.33
肺外结核	1	1.33
其他（不明病原体腹泻和发热）	6	8.00

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