| ObjectivesIn this study,HIV/AIDS patients in the antiviral outpatient department of Dali Second People's Hospital as the research object.The traditional bacterial culture method and real-time fluorescence quantitative PCR method were used to count and quantitatively detect the intestinal flora,Analysizing from a microecological perspective the changes of structure and quantity of intestinal flora in HIV/AIDS patients with different immunity status treated with Highly active antiretroviral therapy(HAART),and studying the role of the changes of intestinal microecology in the pathogenesis and development of patients.It is expected to provide an important theoretical basis for clinicians to improve the quality of life and the therapeutic effect of HAART.Methods1.According to the strict inclusion and exclusion criteria,select 120 HIV/AIDS patients of Dali Second People's Hospital.According to CD4~+T lymphocyte count<200cells/?l,200~500cells/?l and>500cells/?l after HAART treatment,respectively,HIV/AIDS patient were divided into three groups poor immune reconstitution group,the incomplete reconstruction group and the complete reconstruction group(A,B and C),and were assessed by the quality of life measure specific for Chinese people living with HIV/AIDS(QOL-CHIV).2.Collecting feces from three groups of HIV/AIDS patients,selectively culturingculturablemicroorganisms,aerobicbacteria,anaerobicbacteriaand fungi,with Tryptose Soya Agar,Anaerobic Agar Medium and Potato Dextrose Agar(containing chloramphenicol)respectively.And colonies were counted(counted as lgCFU/g).3.Collecting feces from three groups of HIV/AIDS patients,extracting the bacterial genome DNA in feces and The total flora,Bacteroides,Bifidobacterium,Lactobacillus,Escherichia coli and Enterococcus in the intestinal tract of mice were quantitatively detected by real-time fluorescence quantitative PCR.4.Statistical analysis:the SPSS17.0 software was used to analyze whether there were statistical differences in the Quality of life,the number of bacteria and the number of colonies among the three groups.Results1.The total scores of ten dimensions of QOL-CHIV in A group was significantly higher than that of group B(P=0.008),the dimension of appetite and pain in A and C group was significantly higher than that of group B(P=0.007,P=0.020),and the score of the third item of therapeutic efficacy and side effects dimension(the actual situation of taking medicine is more difficult than expected situation)in A group was significantly higher than that of B group(P=0.006).Multiple linear regression analysis showed that education level,treatment time and their health scoring by themselves have dependency relation with the total scores of ten dimensions of QOL-CHIV.2.There was no significant difference between the three groups of aerobic bacteriacultureresults(8.52±0.89),(8.24±0.97)and(8.21±0.93)respectively(P=0.269);The count of anaerobic bacteria in group B(8.64±0.96)was significantly lower than that in group A(9.45±0.85)(P<0.001)and group C(9.22±0.99)(P=0.008),but there was no significant difference between group A and group C(P=0.265);The count of fungi in group A(5.02±1.54)was significantly higher than that in group C(3.97±1.86)(P=0.013),and there was no significant difference between group B and group C and A(P=0.311?P=0.134).The count of anaerobic bacteria in group A and group C was significantly larger than that of aerobic bacteria(P<0.001),but there was no significant difference between the count of anaerobic bacteria and aerobic bacteria in group B(P=0.075).3.The number of fecal bacteria in the poor immune reconstitution group and complete immune reconstitution group were as follows:total intestinal flora(11.60±0.21;11.41±0.33),Bacteroides(10.93±0.35;10.64±0.55)and Escherichia coli(8.68±0.68;8.19±0.96)respectively,demonstrating that there was a significant increase in the poor immune reconstruction group and the difference was statistically significant.The B/E values of the poor immune reconstitution group and the complete reconstruction group were respectively(0.84±0.13;0.91±0.17),the difference was statistically significant.The B/E values of the three groups were less than 1,indicating that the intestinal colonization resistance of the three groups decreased significantly,especially in the poor immune reconstitution group.Conclusions1.There were differences in the scores of quality of life when the effect of immune reconstitution in HIV/AIDS patients after HAART is different,Further study on increasing sample size.2.There were differences in the results of fecal microbial culture when the effect of immune reconstitution in HIV/AIDS patients after HAART is different,and the effect of immune reconstitution may be related to intestinal microecology imbalance.3.The count of fungi in poor immune reconstitution group was significantly higher than that in the complete reconstruction group,there was a negative correlation between the results of fungi count and the baseline CD4 value and the CD4 value after treatment.It is suggested that the effect of immune reconstruction may be associated with intestinal flora imbalance in patients with HIV/AIDS.4.The three groups of subjects have a certain difference in the structure and number of total intestinal flora,Bacteroides and Escherichia coli.The number of total intestinal flora,Bacteroides and Escherichia coli in the poor immune reconstruction group was more than that in the complete immune reconstitution group,the intestinal flora disorder of the patients with poor immune reconstitution is more serious.5.The B/E values of the three groups were less than normal value,indicating that the intestinal colonization resistance of the three groups decreased significantly,especially in the poor immune reconstitution group.The intestinal flora disorder of the patients with poor immune reconstitution is more serious,The decrease of intestinal colonization resistance was more significant.6.HIV/AIDS patients with different immunity status have different degrees of intestinal flora imbalance,and the decrease of intestinal colonization resistance is certainly related to the severity of intestinal flora imbalance. |
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