台州市2017-2018年新报告HIV/AIDS巨细胞病毒血症现患率及影响因素研究

目的了解2017-2018年台州市新报告且未接受抗病毒治疗(ART)的HIV/AIDS血浆巨细胞病毒血症现患率及其影响因素。方法收集台州市新报告且未接受ART的成年HIV/AIDS血浆样本,提取核酸后采用荧光定量PCR检测巨细胞病毒DNA水平,采用单因素与多因素logistic回归分析其影响因素。结果研究对象612例HIV/AIDS中,男性480例(78.4%),年龄>60岁125例(20.4%),同性性传播者177例(28.9%),异性性传播者430例(70.3%)。巨细胞病毒血症现患率为13.4%(82/612)。多因素logistic回归分析结果显示,CD₄⁺T淋巴细胞计数(CD4)≤200个/μl者现患巨细胞病毒血症的风险显著高于CD4>500个/μl者(OR=5.10,95%CI:1.74~14.96,P=0.003);82例现患巨细胞病毒血症者的血浆巨细胞病毒DNA载量(log10)中位数为1.57(P₂₅,P₇₅:1.04,2.13),CD4≤200个/μl者的巨细胞病毒载量最高(P<0.01)。结论2017-2018年台州市新报告未接受ART的HIV/AIDS中,巨细胞病毒血症现患率与免疫缺陷状态显著关联,巨细胞病毒血症对HIV/AIDS病程的影响有待进一步研究。

Prevalence and correlates of plasma cytomegalovirus viremia among newly reported HIV/AIDS patients in Taizhou city, 2017-2018

Objective To study the prevalence and correlates of plasma cytomegalovirus(CMV)viremia among newly reported antiretroviral therapy(ART)-naive HIV/AIDS patients in Taizhou during 2017-2018.Methods CMV DNA was measured in plasma specimens of newly reported ART-naive HIV/AIDS patients by quantitative PCR.Both univariable and multivariable logistic regression analyses were carried out to evaluate CMV viremia correlations among the individuals.Results Of 612 HIV/AIDS patients,480(78.4%)were male,125(20.4%)were over 60 years old,177(28.9%)were infected via homosexual transmission,and 430(70.3%)via heterosexual transmission.The prevalence of CMV viremia among HIV/AIDS patients was 13.4%(82/612).Multivariable logistic regression analysis showed that the risk of CMV viremia in CD₄⁺lymphocyte cells counts(CD₄⁺)≤200 cells/μl group was higher than CD_(40 counts>500 cells/μl(OR=5.10,95%CI:1.74-14.96,P=0.003);The median CMV DNA level(log10)of 82 viremic patients was 1.57(P₂₅,P₇₅:1.04,2.13);Viremic patients with CD_(40 counts≤200 cells/μl had the highest CMV viral load(P<0.01).Conclusions Among ART-naive HIV/AIDS patients,the prevalence of CMV viremia was significantly associated with immunodeficiency status.Further research is needed to evaluate the association between CMV viremia and the course of HIV infection.