CID:联合抗逆转录病毒疗法或可降低HIV患者梅毒测试假阳性率

2013-07-15 陈郁婷 dxy

为判断联合抗逆转录病毒疗法(cART)及免疫抑制程度对HIV感染患者梅毒快速血浆反应素(RPR)测试生物学假阳性(BFP)的影响,来自美国约翰霍普金斯大学医学院的医学博士Ikwo Oboho及其同事展开一项研究,研究结果在线发表于2013年7月3日的Clinical Infectious Diseases(《临床感染疾病》)杂志上。作者发现,cART的使用似乎能够降低RPR测试出现BFP的几率。研

为判断联合抗逆转录病毒疗法(cART)及免疫抑制程度对HIV感染患者梅毒快速血浆反应素(RPR)测试生物学假阳性(BFP)的影响,来自美国约翰霍普金斯大学医学院的医学博士Ikwo Oboho及其同事展开一项研究,研究结果在线发表于2013年7月3日的Clinical Infectious Diseases(《临床感染疾病》)杂志上。作者发现,cART的使用似乎能够降低RPR测试出现BFP的几率。

研究人员以HIV感染患者为对象展开一项回顾性巢式研究,将相应受试者纳入约翰霍普金斯HIV临床队列。他们将RPR反应阳性且荧光螺旋体抗体吸收(FTA-ABS)测试反应阴性定义为BFP RPR。并将测试结果为BFP的患者与另外两个对照组进行比较:HIV感染患者(1)伴有梅毒(RPR和FTA-ABS测试均为阳性)和(2)当前未患梅毒(RPR反应阴性)。持续性BFP的定义是:整个随访期间至少出现两次一致的BFP。

研究结果如下:在711例HIV患者中,96例(13.5%)测试结果出现BFP,342例(48.1%)患有梅毒。在这96例患者中,22例(23%)为持续性BFP。与伴有梅毒[校正优势比(aOR)0.31,5% CI: 0.15-0.63]和RPR测试阴性的患者[aOR 0.42(0.22-0.81)]相比,cART的使用与BFP几率的降低相关。cART的使用也与持续性BFP几率的降低相关[aOR 0.07(0.01-0.33)]。此外,无论是CD4细胞计数,还是HIV RNA水平,均与BFP测试结果无关。RPR滴度更低、年龄更低以及注射吸毒均与BFP几率的增加相关。

研究发现,cART的使用似乎能够降低RPR测试出现BFP的几率。这一发现提示,HIV感染患者非螺旋体滴度的波动或许可反映与梅毒活动无关的因素的影响。


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    2014-02-28 mjldent
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    2013-09-20 xlxchina
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    2014-02-26 hxj0117
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