高效抗反转录病毒治疗（HAART）期间 HIV 感染者口腔念珠菌感染和免疫状态的动态研究。

Dynamic study of oral Candida infection and immune status in HIV infected patients during HAART.

机构信息

College of Stomatology, Chongqing Medical University, 410120, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, 410120, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, 410120, China.

College of Stomatology, Chongqing Medical University, 410120, China.

出版信息

Arch Oral Biol. 2020 Jul;115:104741. doi: 10.1016/j.archoralbio.2020.104741. Epub 2020 May 7.

DOI:10.1016/j.archoralbio.2020.104741

PMID:32417705

Abstract

OBJECTIVE

To dynamically monitor oral Candida infection, CD4 T lymphocyte counts, CD8 T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients during their first year of HAART and to preliminarily explore the relationships between them.

DESIGN

Forty-six patients with HIV/AIDS receiving HAART at the Infection Department of Chongqing Red Cross Hospital were followed for one year. At baseline and 3, 6, and 12 months after HAART initiation, oral rinses were collected and cultured to identify Candida species. Further, blood samples were collected to detect CD4 T lymphocyte counts, CD8 T lymphocyte counts and CD4/CD8 ratios.

RESULTS

The prevalence of OC decreased after HAART initiation (P ＜ 0.05), and Candida albicans was the dominant species isolated from the oral cavity (66/93). At 3, 6 and 12 months after HAART initiation, CD4 T lymphocyte counts were 327.91 ± 138.82, 329.65 ± 142.66 and 319.98 ± 97.90 cells/mm, respectively, which were significantly higher than the level at baseline (263.39 ± 126.01 cells/mm) (P = 0.016, P = 0.014, and P = 0.035, respectively). During the first year of HAART, CD4/CD8 ratios increased gradually, and CD8 T lymphocyte counts decreased continually. OC was associated with low CD4 T lymphocyte counts and a low CD4/CD8 ratio. CD4 T lymphocyte counts <200 cells/mm and Candida load ≥300 CFU/mL were risk factors for OC (P ＜ 0.05), and oral Candida load was negatively correlated with CD4 T lymphocyte counts and the CD4/CD8 ratio.

CONCLUSION

OC might be a useful marker for the evaluation of immune status in patients with HIV/AIDS.

摘要

目的

动态监测 HIV/AIDS 患者接受高效抗逆转录病毒治疗（HAART）后第一年的口腔念珠菌感染、CD4+T 淋巴细胞计数、CD8+T 淋巴细胞计数和 CD4/CD8 比值，并初步探讨它们之间的关系。

设计

对重庆红十字会医院感染科接受 HAART 的 46 例 HIV/AIDS 患者进行为期一年的随访。在 HAART 开始时及开始后 3、6 和 12 个月，采集口腔冲洗液进行念珠菌鉴定，采集血样检测 CD4+T 淋巴细胞计数、CD8+T 淋巴细胞计数和 CD4/CD8 比值。

结果

HAART 开始后口腔念珠菌病（OC）的患病率下降（P＜0.05），口腔分离的优势菌种为白念珠菌（66/93）。HAART 开始后 3、6 和 12 个月，CD4+T 淋巴细胞计数分别为 327.91±138.82、329.65±142.66 和 319.98±97.90 个/ mm，均明显高于基线水平（263.39±126.01 个/ mm）（P=0.016、P=0.014 和 P=0.035）。在 HAART 的第一年，CD4/CD8 比值逐渐升高，CD8+T 淋巴细胞计数持续下降。OC 与 CD4+T 淋巴细胞计数低和 CD4/CD8 比值低有关。CD4+T 淋巴细胞计数＜200 个/ mm 和念珠菌负荷量≥300 CFU/mL 是 OC 的危险因素（P＜0.05），口腔念珠菌负荷量与 CD4+T 淋巴细胞计数和 CD4/CD8 比值呈负相关。