2021-2024年苏州市人类免疫缺陷病毒抗体确证阳性病例的T淋巴细胞亚群水平及病毒载量OA

[Objective]To investigate the T lymphocyte subset levels and viral loads in newly human immunodeficiency virus(HIV)antibody-confirmed positive cases in Suzhou(2021-2024),and to analyze potential influencing factors by integrating their demographic characteristics,immune status,and viral replication patterns,thereby providing evidence for HIV/acquired immune deficiency syndrome(AIDS)prevention and control.[Methods]Peripheral whole blood samples were collected from newly confirmed HIV-positive cases in Suzhou from 2021 to 2024.T lymphocyte subset analysis and viral load testing were performed,and influencing factors were identified in combination with demographic characteristics.Logistic regression models were employed to identify factors associated with CD4+T lymphocyte counts≤350 cells·µL-1,and Spearman's rank correlation test was used to analyze the correlation between logarithmic value of viral load and CD4+/CD8+ratio.[Results]Among the 3 022 confirmed HIV-positive samples,the median CD4+T lymphocyte count was 298.00 cells·µL-1,with 882 cases(29.19%)showing CD4+T lymphocyte counts<200 cells·µL-1.The median CD8+T lymphocyte count was 1 011.00 cells·µL-1.The median CD4+/CD8+ratio was 0.28,with 32.46%of cases exhibiting CD4+/CD8+ratios<0.20,and there were statistically significant differences in CD4+/CD8+ratio among different genders,age groups,marital status,and sample sources(all P<0.05).Multivariate logistic regression analyses indicated that individuals aged≥20 years,those who were divorced or widowed,and cases identified through medical institutions had a significantly higher proportion of CD4+T lymphocyte counts≤350 cells·µL⁻¹ compared to those aged<20 years,unmarried individuals,and cases sourced from voluntary counseling and testing(VCT)clinics,respectively.The mean logarithmic value of viral load was(4.29±1.15)copies·mL-1.The logarithmic value of viral load demonstrated a significantly negative correlation with both CD4+/CD8+ratio(r=-0.43,P<0.001)and CD4+T lymphocyte count(r=-0.37,P<0.001).[Conclusion]A substantial proportion of newly diagnosed HIV/AIDS cases in Suzhou are late presenters with high viral load levels.Targeted interventions should prioritize high-risk populations through enhanced active surveillance and the implementation of combined T lymphocyte subsets analysis and viral load testing,which can enable earlier case-finding and timely antiretroviral therapy initiation.