重庆地区人类免疫缺陷病毒携带者的微孢子虫感染情况调查

目前我国关于微孢子虫感染人的研究相对较少，更没有关于重庆地区人类免疫缺陷病毒(HIV)携带者感染微孢子虫的数据统计。对重庆市公共卫生医疗救治中心收治的22例HIV抗体阳性，但尚未接受抗病毒治疗的患者进行研究。将22例患者粪便样本分别提取总DNA，通过聚合酶链反应(PCR)法和DNA测序等技术对微孢子虫在患者中的感染情况进行检测，并对微孢子虫种类进行鉴定。同时对22例患者的免疫细胞亚群进行计数和分析。结果显示，微孢子虫的感染率为36.3%(8/22)，主要由脑炎微孢子虫属(Encephalitozoon spp)的海伦脑炎微孢子虫(E. hellem)和肠脑炎微孢子虫(E. intestinalis)引起。22例患者的免疫细胞亚群分析显示，平均淋巴细胞数0.93±0.13×10⁹/L，CD4^＋T细胞数132±22 个/mL，CD8^＋T细胞数495±91 个/mL，CD4/CD8细胞比值0.37±0.1，表明患者免疫功能受到严重抑制。进一步将微孢子虫感染患者与未感染患者的免疫细胞亚群进行比较发现，感染患者淋巴细胞数为0.51±0.1×10⁹/L，未感染患者为1.17±0.17 ×10⁹/L，两者具有显著差异(P<0.05)；感染患者CD4^＋T细胞数为71±27 个/mL，未感染患者为167±28 个/mL，两者具有显著差异(P<0.05)；感染患者CD8^＋T细胞数为209±35 个/mL，未感染患者为658±123 个/mL，两者具有显著差异(P<0.05)，以上表明微孢子虫感染组的免疫功能受损情况更严重。本研究结果提示微孢子虫的机会性感染与患者免疫功能受损情况密切相关，脑炎微孢子虫属在重庆地区有较高的感染率，这为进一步阐明微孢子虫与宿主相互作用关系奠定基础，也为公共卫生健康管理提供重要参考。

Microsporidiosis incidences of human immunodeficiency virus-positive patients in Chongqing area

Microsporidia infects immunocompromised populations such as human immunodeficiency virus(HIV)-positive patients, causing diarrhea and other life-threatening symptoms. Few studies on this infection have been conducted in China. This study collected 22 HIV-positive patients in Chongqing, who have not received antiviral treatment. The immune profile analysis of these 22 patients showed the average lymphocytes were 0.93±0.13×10⁹/L, CD4^＋T cells were 132±22 cells/mL, CD8^＋T cells were 495±91 cells/mL, and CD4/CD8 ratio was 0.37±0.1, indicating all the patients were immunocompromised, thus vulnerable to opportunistic infections. The total DNA was extracted from the respective stool samples. The existence of microsporidia was confirmed by PCR and DNA sequencing. The results showed that the infection rate was 36.3% (8/22), and caused by Encephalitozoon spp, mainly E. hellem and E. intestinalis. Further comparison between Encephalitozoon spp infected and un-infected patients showed that, lymphocytes were 0.51±0.1 vs 1.17±0.17×10⁹/L, P<0.05; CD4⁺T cells were 71±27 vs 167±28 cells/ mL, P<0.05; CD8^＋T cells were 209±35 vs 658±123 cells/ mL, P<0.05, suggesting the infected patients were severely immune-suppressed. The current study is the first investigation of microsporidia infection in HIV-positive patients in Chongqing area. It demonstrates the correlation between immune-suppression and microsporidia infection, and the high infection rate of Encephalitozoon spp in Chongqing area. Together, this provides evidence to elucidate the mechanisms of microsporidia-host interactions, as well as insights into public health control.