广西艾滋病马尔尼菲蓝状菌机会性感染的流行病学调查

目的 分析广西HIV/AIDS患者马尔尼菲蓝状菌机会性感染的流行情况,为艾滋病抗反转录病毒治疗提供依据。方法 回顾性分析2013年1月—2017年12月在南宁市第四人民医院感染科住院治疗的6 956例HIV/AIDS患者的临床资料,对筛选出血液或骨髓马尔尼菲蓝状菌培养阳性的患者进行统计分析。结果 广西住院HIV/AIDS患者中马尔尼菲蓝状菌感染率为15.60%（1 085/6 956）。各年龄组HIV/AIDS患者马尔尼菲蓝状菌感染率的差异有统计学意义（P<0.01）, 发病以中壮年为主。男性感染率为16.29%,女性为13.36%,男性高于女性（P<0.01）。不同民族人群的感染率差异无统计学意义（P>0.05）。不同CD4⁺T细胞计数患者的感染率比较差异有统计学意义（P<0.01）,以≤50 cells/μL者感染率最高（33.03%）。桂东地区感染率最高（20.72%）,桂北地区最低（12.70%）。季节里4月份感染率最高（22.31%）。结论 广西住院HIV/AIDS患者中马尔尼菲蓝状菌的感染率为15.60%,作为广西艾滋病常见的机会性感染,临床上需要加强对马尔尼菲蓝状菌的诊断和治疗。

The epidemiology of Talaromyces marneffei infection in HIV-infected patients in Guangxi

Objective To explore the prevalence of Talaromyces marneffei infection in HIV-infected patients in Guangxi in order to provide a basis for the antiretroviral therapy of acquired immunodeficiency syndrome in future. Methods A retrospective analysis of clinical data of 6 956 cases of HIV-infected patients in the Fourth People's Hospital of Nanning from January 2013 to December 2017, then we chose patients who were positive in blood or bone marrow culture for Talaromyces marneffei and counted the results. Results The crude rate of prevalence of Talaromyces marneffei in Guangxi was 15.60%（1 085/6 956）. The prevalence rates of different age groups showed significant differences (P<0.01), and the most common ages were adults group. Prevalence in males was 16.29%, with females as 13.36%, and the difference between genders was significant (P<0.01). The prevalence rates of Talaromyces marneffei in different ethnic groups were not significant different(P>0.05). The prevalence rates among different CD4 lymphocytes were statistically significant(P<0.01), and the highest prevalence rate was found in patients with ≤ 50 cells/mL (33.03%). The prevalence rate was the highest in eastern Guangxi (20.72%) and the lowest in northern Guangxi (12.70%). Talaromyces marneffei occurred mainly in April (22.31%). Conclusion The proportion of Talaromyces marneffei infection in HIV-infected inpatients in Guangxi is 15.60%. As a common opportunistic infection of HIV-infected patients, it is necessary to strengthen the diagnosis and treatment of Talaromyces marneffei in clinic.