HIV感染者超声洁治术中的传播风险研究

目的分析HIV感染者超声牙周洁治术中HIV传播的影响因素。方法选取北京佑安医院感染科50例HIV男性感染者,记录龈沟出血指数(sulcus bleeding index,SBI)和CD4^+T淋巴细胞计数;应用EasyQ分析仪检测血液、超声洁治术中的血唾混合液(blood saliva mixture,BSM)的HIV病毒载量(viral load,VL)。通过ROC曲线寻找连续变量的最佳截断值,采用Logistic回归分析血唾混合液病毒载量(blood saliva mixture viral load,BSMVL)的影响因素。结果在BSM有、无病毒载量的两组研究对象之间,SBI水平和血液病毒载量(blood viral load,BVL)的差异有统计学意义(P<0.05),SBI和BVL的最佳截断值分别为3和6000 copies/mL;通过Logistic回归发现,BVL是BSMVL的独立危险因素(OR=21.0,95% CI: 4.0,110.1)。结论BSMVL是衡量超声洁治术中HIV传播风险的核心指标。SBI、BVL的升高,可增加BSMVL,加大HIV传播风险;CD4^+T淋巴细胞计数不作为HIV传播风险的参考。

Risk of HIV transmission during ultrasound scaling for HIV-infected patients

Objective To analyze the factors influencing HIV transmission during ultrasonic periodontal scaling for HIV-infected patients. Methods Fifty male patients with HIV infection in the Infectious Diseases Department of Beijing Youan Hospital were selected to record SBI (sulcus bleeding index) and CD4^+T lymphocyte counts. the blood viral load (BVL) and blood–saliva mixture viral load (BSMVL) of HIV during the ultrasound scaling were measured by the EasyQ analyzer. The best cut-off value of continuous variables was defined by ROC curve. The influencing factors of BSMVL were explored by logistic regression. Results There were significant differences in SBI level and BVL between the two groups with and without viral load in BSM (P<0.05). The best cut-off values of SBI and BVL were 3 and 6 000 copies/mL. Logistic regression showed that BVL was an independent risk factor for BSMVL (OR=21.0, 95% CI: 4.0, 110.1). Conclusions BSMVL is the key index to evaluate the risk of HIV transmission during ultrasound scaling. The elevated SBI and BVL caused higher risk of HIV transmission by increasing BSMVL. CD4^+T lymphocyte count should not be the reference for the risk of HIV transmission.