Correlation Between Hiv-opportunistic Infection And Serun CD4~+T Cells,CD8~+T Celles,IL-10,TNF-? Levels

Objective:Through the research in Nanning the Fourth People's Hospital treated 124 cases of opportunistic infection of AIDS patients and to explore different CD4+T cell count and the relationship between the incidence of opportunistic infection of AIDS,and not HAART treatment with HAART treatment of AIDS patients in different CD4+T cell count and the segmentation of opportunistic infections also discusses the CD8+T lymphocytes and cytokines IL-10,the TNF-? in different level difference of opportunistic infection of AIDS patients.Methods:124 AIDS patients who received treatment in the fourth people's hospital of Nanning city from July 2017 to September 2018 were collected,among which 53 cases had no infection and 71 cases had opportunistic infection.There were 52 patients without HAART treatment and 72 patients who had received HAART treatment.First,a descriptive analysis was conducted on the opportunistic infection of 124 AIDS patients.The patients were divided into four groups according to CD4+T cell levels:0-50/uL,51-200/uL,201-350/uL,and>350/uL.The incidence of opportunistic infection in the four groups was compared.The incidence of opportunistic infection at different CD4+T cell levels in patients treated with HAART and without HAART was compared.Serum CD8+T lymphocyte number,IL-10 and TNF-? levels were detected in two groups:the group without opportunistic infection and the group with opportunistic infection.The CD4+T and CD8+T cell counts in the serum of all AIDS patients were detected by flow cytometry,and serum IL-10 and TNF-?levels were detected by enzyme-linked immunosorbent assay(ELISA).Results:(1)124 cases of AIDS patients,patients with 71 cases of opportunistic infection,the incidence of opportunistic infection was 57.26%,53 cases of men,women,18 cases of male to female ratio is 3:1,aged 15-76,the average age was(43.21±1.48),71 cases of opportunistic infections in AIDS patients,with fungal infection most,43 cases of fungal infections(60.56%,including Carlyle marney fe penicillium 20 cases of infection,candida albicans infection in 17 cases,6 cases of pneumocystis infection,cryptococcus infection in 2 cases);There were 39 cases of viral infection(54.93%,including 35 cases of cytomegalovirus infection and 25 cases of herpes virus infection).Third,there were 25 cases(35.21%)of mycobacterium tuberculosis infection.There were also 16 cases(22.54%)of bacterial infection and 1 case(1.41%)of toxoplasma infection.(2)Among 124 AIDS patients,53(42.74%)had no opportunistic infection,and the mean number of CD4+T cells was(370.55±30.02)/ul.There were 71 patients(57.26%)with opportunistic infection,and the mean number of CD4+T cells was(96.79 ± 14.00)/ul,including 22 patients(17.74%)with one pathogen infection,and the mean number of CD4+T cells was(114.68±29.05)/ul.The mean number of CD4+T cells was(108.68±21.92)/ul.Thirteen patients(10.48%)were infected with the three pathogens,and the mean number of CD4+T cells was(89.15±36.27)/ul.The mean number of CD4+T cells was(45.60±22.83)/ul.There were 2 patients(1.61%)complicated with 5 pathogens(few patients did not participate in the statistical analysis).The number of CD4+T cells in the group without opportunistic infection was significantly higher than that in the group with opportunistic infection,and the difference was statistically significant(P<0.05).(3)The incidence of opportunistic infection with the number of CD4+T cells 0-50/uL,51-200/uL,201-350/uL,and 350/u>was 87.80%,75.00%,45.83%,and 9.68%,respectively.The incidence of opportunistic infection with the number of CD4+T cells 0-50/u was significantly lower than that of other groups(x 2=49.19,P<0.05).(4)Thepositive rates of penicillium marneffei infection and cytomegalovirus infection with the number of CD4+T cells in 50/uL group were significantly higher than those in the other three groups(P<0.05)(5)There were 41 patients with 0-50 CD4+T cells/uL,7 patients with HAART treatment and 6 patients with opportunistic infection.28 patients had a CD4+T cell count of 51-200/uL,17 patients had been treated with HAART,and 12 patients had opportunistic infection.There were 24 patients with CD4+T cell count of 201-350/uL,20 patients with HAART treatment,and 8 patients with opportunistic infection.There were 31 patients with CD4+T cell count of>350/uL,28 patients with HAART treatment,and 2 patients with opportunistic infection.The incidence of opportunistic infection in the HAART group was lower than that in the non-haart group,and the difference was statistically significant(x 2=17.42,P<0.05).Pairwise comparison:Has HAART treatment group in CD4+T cell number 0 to 50/uL and the CD4+T cell number 51-200/uL low incidence of opportunistic infections with HAART treatment group the incidence of opportunistic infections there was no statistically significant difference(P>0.05),has HAART treatment group on CD4+T cell number 200-350/uL and the CD4+T cell number 51-200/uL incidence of opportunistic infections with HAART treatment group the incidence of opportunistic infections there was no statistically significant difference(P>0.05),Among the other groups,the incidence of opportunistic infection in the group treated with HAART was lower than that in the group not treated with HAART,and the comparison was statistically significant(P<0.05).(6)The number of CD8+T cells in the opportunistic infection group was(645.42±97.90)ul,and the number of CD8+T cells in the non-opportunistic infection group was(938.57±61.54)ul.The number of CD8+T cells in the opportunistic infection group was significantly lower than that in the non-opportunistic infection group,with statistically significant differences(P<0.05).(7)The concentrations of IL-10 and TNF-? in the opportunistic infection group were(382.63±62.05)ng/L and(519.54±68.51)ng/L,respectively,while those in the opportunistic infection group were(322.70 ± 59.97)ng/L and(402.15 ± 56.08)ng/L,respectively.All the differences were statistically significant(P<0.05).Conclusion:(1)Fungal infection,viral infection and tuberculosis infection are the most common opportunistic infections in AIDS patients in Guangxi.(2)The incidence of opportunistic infection in AIDS patients is closely related to the number of CD4+T cells in patients.The lower the number of CD4+T cells,the higher the incidence of opportunistic infection and the more the number of opportunistic infections.(3)The changes in serum CD4+T cells can actively prevent the occurrence of opportunistic infection in AIDS patients.When the number of CD4+T cells is less than 200/ul,the occurrence of opportunistic infection should be actively prevented.When CD4+T cells are reduced to 50/ul,multiple pathogen mixed infections,especially fungal infections,must be vigilant and must be prevented,diagnosed,and treated early.(4)The incidence of opportunistic infection in AIDS patients who have been treated with HAART is still high,but it is lower than that in AIDS patients who have not been treated with HAART.(5)The incidence of opportunistic infection in AIDS patients may be related to the number of CD8+T cells in patients,and the lower the number of CD8+T cells in patients' serum,the more likely opportunistic infection is to occur.(6)Serum IL-10 and TNF-? levels are correlated with opportunistic infection to some extent.SerumIL-10 and TNF-? levels are increased when opportunistic infection occurs.Be alert for opportunistic infections when serum IL-10 and TNF-? levels are elevated.