HIV感染/AIDS患者合并EB病毒和巨细胞病毒感染的影响因素与免疫指标分析

doi:10.19871/j.cnki.xfcrbzz.2026.03.004

摘要/Abstract

摘要： 目的分析HIV感染/AIDS患者合并EB病毒（Epstein-Barr virus,EBV）和巨细胞病毒（cytomegalovirus,CMV）感染的影响因素及相关免疫指标特征,为临床早期筛查与诊疗提供参考。方法回顾性收集2024年1月1日至12月31日南京市第二医院384例HIV感染/AIDS患者的临床资料,采用流式细胞术检测外周血CD4⁺T淋巴细胞计数,实时荧光定量聚合酶链反应法检测HIV RNA、EBV DNA及CMV DNA载量。通过多因素Logistic回归分析HIV感染/AIDS患者合并EBV和CMV感染的影响因素;Spearman秩相关分析CD4⁺T淋巴细胞计数与HIV RNA载量的相关性。结果 384例HIV感染/AIDS患者中,80例合并EBV和CMV感染,合并感染率为20.8%;不同CD4⁺T淋巴细胞计数组间合并感染率差异具有统计学意义（χ²=42.573,P<0.001）。多因素Logistic回归分析结果显示,年龄>50岁,CD4⁺T淋巴细胞计数<200个/μl,HIV RNA载量≥200copies/ml是HIV感染/AIDS患者合并感染EBV和CMV的独立危险因素（均P<0.05）。相关性分析结果显示,合并EBV和CMV感染患者CD4⁺T淋巴细胞计数与HIV RNA载量呈负相关（r=-0.336,P=0.002）。结论年龄>50岁、CD4⁺T淋巴细胞计数<200个/μl与HIV RNA载量≥200copies/ml可增加HIV感染/AIDS患者合并EBV和CMV感染的风险,且合并感染可进一步加重机体免疫损伤。临床应对此类高危人群开展主动筛查、早期识别并及时干预,以改善患者预后。

关键词: 人类免疫缺陷病毒, 获得性免疫缺陷综合征, EB病毒, 巨细胞病毒, 合并感染, CD4⁺T淋巴细胞计数, 病毒载量

Abstract: Objective To investigate the influencing factors and related immune marker characteristics of co-infection with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in patients with HIV infection/AIDS, so as to provide a reference for early clinical screening, diagnosis and treatment. Method Clinical data of 384 patients with HIV infection/AIDS were retrospectively collected from January 1 to December 31, 2024 at the Second Hospital of Nanjing. Peripheral blood CD4⁺T lymphocyte count was detected by flow cytometry, and loads of HIV RNA, EBV DNA and CMV DNA were measured by real-time fluorescent quantitative polymerase chain reaction. Multivariate Logistic regression was used to analyze the influencing factors of EBV and CMV co-infection. Spearman rank correlation was applied to evaluate the correlation between CD4⁺T lymphocyte count and HIV RNA load. Result Among the 384 HIV/AIDS patients, 80 had EBV and CMV co-infection, with a co-infection rate of 20.8%. The difference in co-infection rate among groups with different CD4⁺T lymphocyte counts was statistically significant (χ²=42.573, P<0.001). Multivariate Logistic regression analysis showed that age >50 years, CD4⁺T lymphocyte count <200 cells/μl, and HIV RNA load ≥200 copies/ml were independent risk factors for EBV and CMV co-infection (all P<0.05). Correlation analysis revealed that CD4⁺T lymphocyte count was negatively correlated with HIV-RNA load in HIV-EBV-CMV co-infected patients (r=-0.336, P=0.002). Conclusion Age >50 years, CD4⁺T lymphocyte count <200 cells/μl and HIV RNA load ≥200 copies/ml increase the risk of EBV and CMV co-infection in HIV-infected/AIDS patients, and co-infection can further aggravate immune impairment. Active screening, early identification and timely intervention should be carried out for such high-risk populations to improve the prognosis.

Key words: Human immunodeficiency virus, Acquired immune deficiency syndrome, Epstein-Barr virus, Cytomegalovirus, Co-infection, CD4⁺T lymphocyte count, Viral load

中图分类号:

R512.91
R373

季凯歌, 陈影影, 刘冰雪, 许坦, 腾晓燕, 李金龙. HIV感染/AIDS患者合并EB病毒和巨细胞病毒感染的影响因素与免疫指标分析[J]. 新发传染病电子杂志, 2026, 11(3): 19-23.

Ji Kaige, Chen Yingying, Liu Bingxue, Xu Tan, Teng Xiaoyan, Li Jinlong. Analysis of influencing factors and immune indicators of EBV and cytomegalovirus co-infection in patients with HIV infection/AIDS[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(3): 19-23.

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