内科

目的探讨男男性行为(MSM)HIV/AIDS患者病情快速进展的影响因素，为AIDS疫情防控提供参考。方法选取2018年1月至2020年5月在柳州市人民医院感染病科门诊接受HAART的MSM HIV/AIDS患者为研究对象。根据患者接受HAART时的CD4+T淋巴细胞计数或治疗1年内患者的CD4+T淋巴细胞计数变化情况将患者分为快速进展组(94例)、非快速进展组(60例)，比较两组患者的年龄、婚姻状况、职业、文化程度等人口学特征；比较两组患者的基线CD4+T淋巴细胞计数、基线CD8+T淋巴细胞计数、淋巴细胞计数、白细胞计数、CD4/CD8比值及主要性交方式等基线资料及性行为特征；对影响患者病情快速进展的危险因素进行多因素Logistic回归分析。结果两组患者的年龄、婚姻状况、职业、文化程度比较，差异均无统计学意义(P＞0.05)；两组患者的基线CD4+T淋巴细胞计数、基线CD8+T淋巴细胞计数、淋巴细胞计数、白细胞计数、CD4/CD8比值及主要性交方式比较，差异均有统计学意义（P＜0.05）。多因素Logistic回归分析结果显示，CD8+T淋巴细胞计数、CD4/CD8比值、主要性交方式均为影响MSM HIV/AID患者病情快速进展的独立危险因素（P＜0.05）。结论CD8+T淋巴细胞计数、CD4/CD8比值、主要性交方式均为影响男男性行为HIV/AID患者病情快速进展的独立危险因素；结合不同的细胞免疫缺陷状况对患者进行针对性的性行为干预，对延缓病情进展可能会取得更好的效果。

ObjectiveTo investigate the influencing factors for rapid progression of HIV/AIDS patients in men who have sex with men (MSM), to provide reference for AIDS epidemic control and prevention. MethodsMSM HIV/AIDS patients who received HAART in the Outpatient Department of Infectious Diseases, Liuzhou People′s Hospital, Guangxi, from January 2018 to May 2020 were selected as the research objects. According to the CD4+T lymphocyte count at the time of receiving HAART or the change of CD4+T lymphocyte count within 1 year of treatment, the patients were divided into rapid progression group (n=94) and non rapid progression group (n=60). The demographic characteristics of the two groups were compared, such as age, martial status, career, literacy, etc. Both groups′ sexual behavior characteristics and the baseline information including baseline CD4+ T lymphocyte count, baseline CD8+ T lymphocyte count, lymphocyte count, white blood cell count, CD4/CD8 ratio and major sexual intercourse patterns were compared. And the multivariate logistic regression analysis was used to identify the risk factors affecting the rapid disease progression. ResultsThere were no statistically significant differences in age, marital status, career and literacy between the two groups (P＞0.05). The differences in baseline CD4+ T lymphocyte count, baseline CD8+T lymphocyte count, lymphocyte count, white blood cell count, CD4/CD8 ratio and major sexual intercourse patterns between the two groups were statistically significant. Multivariate logistic regression analysis showed that CD8+ T lymphocyte count, CD4/CD8 ratio and major sexual intercourse pattern were independent risk factors affecting the rapid progression of the disease of MSM HIV/AID patients. ConclusionCD8+ T lymphocyte count, CD4/CD8 ratio and major sexual intercourse pattern were independent risk factors affecting the disease′s rapid progression of MSM HIV/AID patients. Combined with different cellular immune deficiency status, targeted sexual behavior intervention for patients may achieve better results in delaying the progress of the disease.