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目的了解深圳市HIV/AIDS病人口腔念珠菌检出情况,系统分析其可能的相关因素和意义。方法采集571例HIV/AIDS患者的口腔粘膜拭子,采用CHROMagar念珠菌显色培养基培养,API-20C-AUX鉴定系统鉴定到种,同时通过国家艾滋病综合防治信息系统查找相关流行病学、治疗、检测等信息进行单因素和多因素分析。结果 571例HIV/AIDS患者中有174例(30.5%)检出口腔念珠菌,所分离到的念珠菌188株以白色念珠菌(70.7%)和克柔念珠菌(10.1%)为主;单因素和多因素分析发现,该人群口腔念珠菌检出在CD4计数、病毒载量以及感染途径这三项上差异有统计学意义(P<0.01)。其中,CD4计数<200个/ml者和病毒载量>10000copies/ml者检出率明显高于同项其他组;不同感染途径中经吸毒和母婴途径感染者检出率较高,男男同性恋人群口腔念珠菌检出率低于经异性感染者。此外,还发现抗病毒治疗<30d者其口腔念珠菌检出率最高,随着抗病毒治疗时间的延长,检出率逐渐降低。结论口腔念珠菌检出率与CD4计数、病毒载量高度相关,与治疗时间也有关联;检出率可能对HIV/AIDS患者判断临床病毒学及免疫学预后有一定参考价值;其受不同感染途径的影响较大,尤其是本研究中在男男同性恋人群偏低的原因值得进一步研究。
Objective To understand the detection of Candida albicans in HIV / AIDS patients in Shenzhen and to systematically analyze the possible related factors and their significance. Methods Oral mucosal swabs were collected from 571 HIV / AIDS patients, cultured in CHROMagar Candida chromogenic medium and identified by API-20C-AUX identification system. At the same time, the epidemiology and treatment were searched through National AIDS Integrated Prevention and Control Information System , Testing and other information for single factor and multivariate analysis. Results Of the 571 HIV / AIDS patients, Candida albicans was detected in 174 cases (30.5%), and Candida albicans (70.7%) and Candida krusei (10.1%) were isolated in 188 cases. Single The factors and multivariate analysis showed that there was significant difference in the count of Candida oralis, the viral load and the route of infection among the three groups (P <0.01). Among them, the detection rate of CD4 counts <200 / ml and viral load> 10000copies / ml was significantly higher than other groups in the same item; Candida candida in homosexuals is lower than that of heterosexual ones. In addition, it was found that the detection rate of oral candidiasis was the highest in antiviral therapy <30 days, and the detection rate decreased gradually with the prolongation of antiviral therapy. Conclusion The detection rate of oral Candida is highly correlated with CD4 count and viral load, and also with the time of treatment. The detection rate may have some reference value for judging clinical virology and immunological prognosis in HIV / AIDS patients. It is affected by different infection routes Of the larger impact, especially in this study, the reasons for the low prevalence of gay men worthy of further study.