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目的了解既往有偿供血人群艾滋病病毒Ⅰ型(HIV-1)感染者的疾病进展状况,分析疾病进展过程中免疫缺损与临床表现间的关系。方法选择安徽某地区未服用抗病毒药的HIV-1阳性既往供血员,通过横断面调查,收集人口学、近期症状/体征、血液学及CD4+细胞计数。结果294名研究对象中,49人的CD4+细胞计数≥500个/μl,83人在350~499个/μl,85人在200~349个/μl,77人<200个/μl。研究对象经历了各类临床表现,最常见的症状是经常性疲乏(35.4%),体重减轻(24.5%),食欲不振(22.1%),出现体重减轻、发热、皮疹、口腔白斑者的CD4+细胞计数的中位数分别为225、245、214、75,明显低于无上述症状者;最常见的体征是皮肤(12.9%)和口腔黏膜(7.8%)的异常表现,CD4+细胞计数的中位数分别为160、216,显著低于未出现者;最常见的血液学异常是中性粒细胞(47.2%)、嗜酸性粒细胞(34.5%)及血细胞压积(23.5%)减少,出现贫血,血细胞压积,单核细胞、淋巴细胞、中性粒细胞减少的CD4+细胞计数的中位数分别为172、189、195、119、276,明显低于未出现者。结论该人群在感染HIV-1的10余年后,处于免疫缺陷期,免疫缺陷早、中、晚期的比例分别为16.7%、28.2%、28.9%及26.2%。口腔白斑、皮疹、体重减轻、长期发热、贫血、血细胞压积、淋巴细胞减少的出现,与免疫缺陷程度密切相关。
Objective To understand the status of the disease in HIV-1 infected patients and to analyze the relationship between immune deficiency and clinical manifestations in the process of disease progression. Methods HIV-1 positive former blood donors who did not take antiviral drugs in a certain area of Anhui Province were selected. Demographic, recent symptoms / signs, hematology and CD4 + cell count were collected through cross-sectional survey. RESULTS: Of the 294 subjects, 49 had CD4 + cell counts ≥500 / μl, 83-460 / μl, 85-300%, 77/21/200 μl. Subjects underwent various clinical manifestations. The most common symptoms were recurrent fatigue (35.4%), weight loss (24.5%), loss of appetite (22.1%), loss of body weight, fever, rashes, oral leukoplakia CD4 + cells The median counts were 225,245,214,75, respectively, which were significantly lower than those without the above symptoms. The most common signs were abnormalities in the skin (12.9%) and oral mucosa (7.8%). The median CD4 + cell count The numbers were 160,216, significantly lower than those who did not; the most common hematological abnormalities were neutrophils (47.2%), eosinophils (34.5%) and hematocrit (23.5%), with anemia , Hematocrit, monocytes, lymphocytes, neutropenia CD4 + cell counts were 172,189,195,119,276, respectively, was significantly lower than those who did not appear. CONCLUSIONS: The population is immunodeficient 10 years after being infected with HIV-1. The rates of early, middle, and late immunodeficiency were 16.7%, 28.2%, 28.9% and 26.2%, respectively. Oral leukoplakia, rash, weight loss, long-term fever, anemia, hematocrit, lymphopenia appear, and the degree of immune deficiency are closely related.