Weiss P J, Brodine S K, Goforth R R, Kennedy C A, Wallace M R, Olson P E, Garland F C, Hall F W, Ito S I, Oldfield E C
Department of Internal Medicine, (Infectious Disease Division), Naval Hospital, San Diego, CA 92134-5000.
J Infect Dis. 1992 Nov;166(5):1149-53. doi: 10.1093/infdis/166.5.1149.
Initial CD4 lymphocyte counts were studied in 244 patients with human immunodeficiency virus (HIV) seroconversion. The CD4 cell counts at initial presentation after seroconversion were normally distributed (mean, 579/mm3; SD, 252). The mean percentage of CD4 cells was 26.1% (SD, 5.6). CD4 cell counts were < 500/mm3 in 41% and < 200/mm3 in 4%. The mean calculated duration of HIV infection was 7.7 months, which was not significantly different between the highest and lowest CD4 count quartiles (8.1 vs. 7.9). Age, sex, race, and serologic evidence of toxoplasmosis, cytomegalovirus, hepatitis B, syphilis, and varicella-zoster virus were not associated with initial low CD4 cell counts; however, never-married men were significantly overrepresented in the lowest quartile. These findings suggest that extensive CD4 lymphocyte depletion is common in early HIV infection and that frequent screening is necessary to identify newly infected patients who would benefit from antiretroviral therapy.
对244例发生人类免疫缺陷病毒（HIV）血清转化的患者进行了初始CD4淋巴细胞计数研究。血清转化后初次就诊时的CD4细胞计数呈正态分布（均值为579/mm³；标准差为252）。CD4细胞的平均百分比为26.1%（标准差为5.6）。41%的患者CD4细胞计数<500/mm³，4%的患者<200/mm³。计算得出的HIV感染平均持续时间为7.7个月，最高和最低CD4计数四分位数之间无显著差异（8.1对7.9）。年龄、性别、种族以及弓形虫、巨细胞病毒、乙型肝炎、梅毒和水痘-带状疱疹病毒的血清学证据与初始低CD4细胞计数无关；然而，未婚男性在最低四分位数中所占比例显著过高。这些发现表明，广泛的CD4淋巴细胞耗竭在早期HIV感染中很常见，并且需要频繁筛查以识别那些将从抗逆转录病毒治疗中获益的新感染患者。
