目的 总结成都市某男男性行为人群(MSM)中人类免疫缺陷病毒(HIV)感染者合并其他传染病的情况,为科学防治艾滋病提供依据。 方法 2010年1月-12月,采用网络、现场、活动场所收发调查问卷,用Excel统计结果数据。 结果 共调查104例艾滋病患者,合并肝炎感染者11例(10.58%),其中乙肝病毒感染者8例(7.69%),丙肝病毒感染者3例(2.88%);合并性传播疾病感染61例(58.65%),其中梅毒感染26例(25%),尖锐湿疣感染者17例(16.35%),生殖器疱疹感染者10例(9.62%),淋病感染者2例(1.92%),沙眼衣原体感染者4例(3.85%),生殖道支原体感染者2例(1.92%);合并真菌感染者87例(62.14%),其中耶氏肺孢子菌感染者6例(5.77%),马尔尼菲青霉菌感染者2例(占1.92%),隐球菌感染者5例(4.81%),组织胞浆菌1例(0.96%);合并结核感染者23例(22.12%)及非结核分枝杆菌3例(2.88%);病毒感染14例(13.46%),全部为水痘-带状疱疹病毒感染;寄生虫感染(弓形虫)1例(0.96%)。 结论 在MSM人群中HIV患者性传播疾病感染比例高;真菌感染率高;结核感染率高;HCV感染和弓形虫感染率低。
Objective To explore the relationship between immune state and disease progression or severity of patients with hepatitis B virus (HBV). Methods A total of 332 patients infected with HBV diagnosed and treated from January 2012 to December 2013 were divided into acute hepatitis B (AHB) group (n=25), chronic hepatitis B (CHB) group (n=237) and cirrhosis group (n=70) according to disease progression. Moreover, CHB group was divided into mild (n=24), moderate (n=103), serious (n=72) and severe group (liver failure group,n=38) according to disease severity, while cirrhosis group was divided into hepatocellular carcinoma (HCC) group (n=13) and non-HCC group (n=57). The immune indexes including immunoglobulin (Ig), complement (C) and T-lymphocyte subsets were tested and compared. Results The immune indexes were not significantly different between AHB group and CHB group (P>0.05). Compared with AHB group and CHB group, cirrhosis group had higher levels of IgG and IgA, and lower levels of CD3+, CD4+ and CD8+ T cells count (P<0.05). Compared with non-HCC group, HCC group had more male patients without antiviral therapy, who had higher levels of C3 and C4 (P<0.05). As disease progressed, the levels of alanine fcell couaminotransferase, aspartate aminotransferase, total cholesterol, Fibroscan index, IgG, and IgA of CHB patients all gradually increased, while the levels of C3 and C4 and the counts of CD3+ and CD4+ T cells gradually declined. Conclusions The immune state of patients infected with HBV has a certain relationship with disease progression or severity, and immunoglobulin, complement and T cells count can partly reflect the severity of the disease. Cirrhosis patients accompanied with high levels of C3 and C4 should pay high attention to antiviral therapy and be vigilant on HCC.