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目的了解天津市经性传播新发感染HIV-1人群的CD4~+T淋巴细胞基线水平,为制定疾病防控政策和临床医生诊疗提供重要信息。方法通过BED HIV-1捕获酶联免疫技术(BED HIV-l incidence capture enzyme immunoassay,BED-CEIA)将205例经性传播感染HIV-1确证阳性者判断为新发感染,对其CD4~+T淋巴细胞数值进行卡方检验和非参数检验。结果男男性行为人群(men who have sex with men,MSM)和异性传播人群HIV-1感染者中CD4~+T淋巴细胞计数<350个/μl所占比例分别为36.67%(55/150)、27.27%(15/55);CD4~+T淋巴细胞计数<500个/μl所占比例分别为73.33%(110/150)、49.09%(27/55),CD4~+T淋巴细胞中位数M(四分位数间距,IQR)分别为395个/μl(201.75个/μl)、501个/μl(398个/μl)。MSM人群感染者中大部分已进入建议治疗时期,CD4~+T淋巴细胞基线水平低于异性传播人群,差异有统计学意义(P=0.001)。MSM人群中≤25岁、26~35岁、≥36岁3个年龄组感染者的CD4~+T淋巴细胞水平差异无统计学意义(P=0.651)。结论天津市经性传播新发感染HIV-1人群尤其是MSM人群的感染者CD4~+T淋巴细胞基线水平较低,确证感染后应尽快检测CD4~+T淋巴细胞,及时启动抗病毒治疗以便获得更好的治疗效果,同时应制订相应的政策,遏制HIV-1经性途径快速传播。
Objective To understand the baseline level of CD4 ~ + T lymphocytes in newly infected HIV-1 patients in Tianjin and to provide important information for the development of disease prevention and control policies and clinicians’ diagnosis and treatment. Methods Totally 205 newly diagnosed HIV-1 positive cases of sexually transmitted infections were identified by BED HIV-1 incidence capture enzyme immunoassay (BED-CEI) and their CD4 ~ + T Lymphocyte values were chi-square test and non-parametric test. Results The CD4 ~ + T lymphocyte counts <350 cells / μl in men who have sex with men (MSM) and heterosexual transmission groups were 36.67% (55/150), respectively, 27.27% (15/55) respectively; the proportion of CD4 ~ + T lymphocyte count <500 / μl were 73.33% (110/150), 49.09% (27/55) respectively, the median of CD4 ~ + T lymphocytes M (interquartile range, IQR) were 395 / μl (201.75 pcs / μl) and 501 pcs / μl (398 pcs / μl), respectively. Most of MSM infected persons have entered the recommended treatment period. The baseline level of CD4 ~ + T lymphocytes is lower than that of heterosexual transmission (P = 0.001). There was no significant difference in CD4 ~ + T lymphocyte levels among MSM population ≤25, 26 ~ 35, ≥36 years old (P = 0.651). Conclusion The baseline levels of CD4 + T lymphocytes in newly infected HIV-1 infected persons in Tianjin, especially in MSM, are lower than those in MSM. Toxic CD4 (superscript +) T lymphocytes should be detected as soon as possible after infection and the antiviral therapy Get better treatment results, at the same time should formulate appropriate policies to curb the rapid transmission of HIV-1 sexual route.