[1]周林颖,刘 兴,伍 勇,等.HIV/AIDS 患者并发EBV 和HCMV 感染临床免疫学特征及影响因素分析[J].现代检验医学杂志,2024,39(02):91-95.[doi:10.3969/j.issn.1671-7414.2024.02.017]
　ZHOU Linying,LIU Xing,WU Yong,et al.Clinical Immunological Characteristic and Influencing Factors Analysis of HIV/AIDS Patients Infected with EBV and HCMV[J].Journal of Modern Laboratory Medicine,2024,39(02):91-95.[doi:10.3969/j.issn.1671-7414.2024.02.017]
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HIV/AIDS 患者并发EBV 和HCMV 感染临床免疫学特征及影响因素分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年02期
页码:
91-95
栏目:
论著
出版日期:
2024-03-31

文章信息/Info

Title:
Clinical Immunological Characteristic and Influencing Factors Analysis of HIV/AIDS Patients Infected with EBV and HCMV
文章编号:
1671-7414（2024）02-091-05
作者:
周林颖; 刘 兴; 伍 勇; 胡金伟
（长沙市第一医院检验科，长沙 410005）
Author(s):
ZHOU Linying;  LIU Xing;  WU Yong;  HU Jinwei
(Department of Clinical Laboratory, the First Hospital of Changsha, Changsha 410005, China)
关键词:
人类免疫缺陷病毒; EB 病毒; 巨细胞病毒; T 淋巴细胞; 艾滋病病毒载量; 抗逆转录病毒治疗
分类号:
R512.91；R373
DOI:
10.3969/j.issn.1671-7414.2024.02.017
文献标志码:
A
摘要:
目的 调查人类免疫缺陷病毒/ 获得性免疫缺陷综合征（human immunodeficiency virus/acquired immune deficiencysyndrome，HIV/AIDS） 患者感染EB 病毒（Epstein-Barr virus，EBV） 和人类巨细胞病毒（human Cytomegalovirus，HCMV）的情况，检测相关临床免疫学指标，分析其影响因素。方法 选取2022 年1~12 月在长沙市第一医院住院并接受EBV 和HCMV 筛查的1 093 例HIV/AIDS 患者。流式细胞术检测CD4+T 淋巴细胞数量；荧光定量PCR 检测HIVRNA载量、EBV-DNA 载量和HCMV-DNA 载量。采用SPSS 27.0 统计学软件进行统计分析, 并通过Logistic 回归分析HIV/AIDS 患者并发病毒感染的危险因素。结果 1 093 例HIV/AIDS 患者中，EBV-DNA 阳性率为48.22%（527/1 093），HCMV-DNA 阳性率为19.03%（208/1 093）。随着CD4+T 淋巴细胞数量增加，EBV-DNA 和HCMV-DNA 的阳性率下降（χ2=39.50，143.0，均P<0.001）；随着HIV-RNA 载量增加，EBV-DNA 和HCMV-DNA 的阳性率增加，差异具有统计学意义（χ2=46.18，124.3，均P<0.001）。另外，患者接受抗逆转录病毒治疗（antiretroviral therapy，ART）也可明显降低EBV-DNA 和HCMV-DNA 的阳性率，差异具有统计学意义（χ2=30.60，96.59，均P<0.001）。CD4+T 淋巴细胞数量和HIV-RNA 载量有显著的负相关关系（r=-0.49，P<0.001）。Logistic 回归分析显示CD4+T 淋巴细胞数量<200 个/μl（OR=1.46，95%CI:1.02~2.08，P=0.037），HIV-RNA 载量>200 copies/ml（OR=1.70，95%CI:1.18~2.44，P=0.004），年龄>30 岁（OR=2.15，95%CI:1.44~3.19，P<0.001）是HIV/AIDS 患者并发EB 病毒感染的危险因素；未持续接受ART（OR=1.83，95%CI:1.10~3.02，P=0.019），HIV-RNA 载量>200 copies/ml（OR=2.56，95%CI:1.50~4.35，P<0.001），CD4+T 淋巴细胞数量<200 个/μl（OR=4.61，95%CI:2.57~8.28，P<0.001）是HIV/AIDS 患者并发HCMV 感染的危险因素。结论 在艾滋病的治疗与管理中，当CD4+T 淋巴细胞数量下降（<200 个/μl），HIV-RNA 载量升高（>200 copies/ml）或者年龄>30 岁时，应加强对病毒的监测和ART，减少HIV/AIDS 患者机会性感染的可能。
Abstract:
Objective To investigate the basic information of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients who infected with Epstein-Barr virus (EBV) or human Cytomegalovirus (HCMV), collect the relevant clinical immunological data and analyze the influencing factors. Method A total of 1 093 HIV/AIDS patients treated in the First Hospital of Changsha from January to December 2022 and underwent EBV and HCMV screening were collected. Flow cytometry was used to detect the CD4+T lymphocytes. Fluorescence quantitative PCR was applied for HIV-RNA, EBV-DNA, and HCMV-DNA testing. Statistical analysis was carried out by using SPSS 27.0, and logistic regression was used to analyze the risk factors of HIV/AIDS patients complicated with viral infection. Results Among 1 093 HIV/AIDS patients, the positive rates of EBV-DNA and HCMV-DNA were 48.22%(527/1 093) and 19.03%(208/1 093), respectively. As the number of CD4+T lymphocytes increased, the positive rates of EBV-DNA and HCMV-DNA decreased, and the differences was statistically significant(χ2=39.50, 143.0, all P<0.001). As the level of HIV-RNA increased, the positive rates of EBV-DNA and HCMV-DNA increased, and the differences were statistically significant(χ2=46.18, 124.3, all P<0.001). The patients receiving antiretroviral therapy (ART) significantly decreased the positive rates of EBV-DNA and HCMV-DNA (χ2=30.60, 96.59, all P<0.001). There was a significant negative correlation between the number of CD4+T lymphocytes and the level of HIV-RNA (r=-0.49, P<0.001). Logistic regression analysis showed that the CD4+T lymphocyte count < 200/μl (OR=1.46, 95%CI:1.02~2.08, P=0.037), HIV-RNA load > 200 copies/ml (OR=1.70, 95%CI:1.18~2.44, P=0.004) and the age > 30 years old (OR=2.15, 95%CI:1.44~3.19, P<0.001) were risk factors for HIV/AIDS patients infected with EBV. Without regularly receiving ART (OR=1.83, 95%CI:1.10~3.02, P=0.019), HIV-RNA load > 200 copies/ml (OR=2.56, 95%CI:1.50~4.35, P<0.001) and the CD4+T lymphocyte count < 200/μl (OR=4.61, 95%CI:2.57~8.28, P<0.001) were risk factors for HCMV infection in HIV/AIDS patients. Conclusion To reduce the possibility of opportunistic infection in HIV/AIDS patients, the surveillance of EBV and HCMV and regular ART should be strengthened, especially when the number of CD4+T lymphocytes decreases (<200/μl), the level of HIV RNA increases (>200 copies/ml) or the age > 30 years old.

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备注/Memo

备注/Memo:
基金项目： 湖南省卫健委湖南省自然科学基金（2023JJ40066）：虚拟筛选以Ltas 蛋白为靶点的活性小分子抑制耐甲氧西林金黄色葡萄球菌的相关研究；长沙市卫健委长沙市自然科学基金（kq2208455）：高通量筛选小分子化合物并探究其对耐甲氧西林金黄色葡萄球菌的抗菌作用。
作者简介：周林颖（1997-），女，硕士，技师，研究方向：临床病原微生物学，E-mail: zly123_321zly@163.com。
通讯作者：胡金伟（1980-），男，硕士，副主任技师，研究方向：临床病原微生物学，E-mail: cshujinwei@163.com。
更新日期/Last Update: 2024-03-15