云南省玉溪市未抗病毒治疗HIV/AIDS患者T淋巴细胞计数自然变化

目的 探讨玉溪市未抗病毒治疗HIV感染者/艾滋病患者（HIV/AIDS）T淋巴细胞计数（CD3、CD4和CD8）自然变化,了解其艾滋病自然病程。方法 收集2006—2014年间玉溪市新报告HIV/AIDS未抗病毒治疗资料,获取首次与末次CD3、CD4和CD8数据,描述并比较CD3、CD4和CD8自然变化速率。结果 CD3、CD4和CD8月均自然变化速率分别为4.14个/μL、-2.13个/μL和7.57个/μL。其中886例（62.66%）CD4末次较首次低,表现为自然下降。首次CD4越高,其月均下降越快,而首次CD4较低,其月均下降较慢甚至出现上升,差异有统计学意义（P<0.05）。男性、汉族、≥50岁者、传播途径为注射吸毒者月均CD4自然变化下降速率较快,而女性、少数民族、50岁以下者、传播途径为性传播者CD3、CD8上升速率较快,差异均有统计学意义（P均<0.05）。结论 玉溪市HIV/AIDS CD3、CD4和CD8自然变化总体平缓,但仍然有部分HIV/AIDS的CD4下降较快,或是CD3 、CD8上升较快,需对该类人群加强随访,及时介入抗病毒治疗。

Changes related to the natural CD3+, CD4+, CD8+ T cell counts among antiretroviral treatment -naive HIV/AIDS patients in Yuxi,Yunnan

Objective To explore the HIV disease progression and the changes related to the natural CD3⁺, CD4⁺, CD8 ⁺T cell counts among antiretroviral treatment -naive HIV/AIDS patients in Yuxi prefecture. Methods The counts of CD3⁺, CD4⁺, CD8⁺ T cell were collected with retrospective study from 2006 to 2014. Difference and change rate of CD3⁺, CD4 ⁺, CD8⁺T cell counts was calculated and described. Results The mean natural change rates of CD3, CD4 and CD8 were 4.14/μL, -2.13/μL and 7.57/μL, respectively. About 886 cases（62.66%） of the HIV/AIDS patients had deletions of CD4⁺T cell counts. The higher the primary CD4⁺ T cell counts was, the faster the decline of CD4⁺T cell counts between the first and the last, while the lower the primary CD4⁺ T cell counts was, the slower the decline of CD4⁺T cell counts between the first and the last, there were of statistical significance (P<0.05). Results from the statistical analysis indicated that male, the Han ethnicity, the people aged 50 or more, transmission mode was injecting drug using were significantly associated with the significant depletion of CD4⁺ T cell counts, while that female, minority, the people under the age of 50, transmission mode was sex were significantly associated with the significant uptrend of CD3⁺, CD8⁺T cell counts (all of P<0.05). Conclusion The changing rate of CD3⁺, CD4⁺, CD8⁺T cell counts among ART- naïve HIV infected patients in Yuxi prefecture was relatively slow. However, substantial proportion of them showed significant decreases of CD4⁺ T cell counts, or some of them showed significant increases of CD3⁺, CD8⁺T cell counts, which was determined by many factors, consistently follow-up those HIV infected patients were needed and the initiation of ART, if necessary.