People Infected With HIV And Toxoplasma Gondii In Henan Province

1 BackgroundAIDS is one of the most serious challenge diseases to human health. About 70 million people are infected worldwide and nearly 3,000 million people dead because infected with HIV. Due to the large population and outbreak of infection in some areas, our province is one of the high incidence of the AIDS epidemic. There is a large absolute number of people living with HIV. According to Henan CDC data, there is a total of 59,380 cases of confirmed AIDS and 18,962 cases of cumulative mortality until October 31,2014. The cumulative number of reported HIV infection has ranked second in our country. AIDS prevention and control in our province is still not optimistic. With the increasing of HIV infection and changing of people infected, AIDS has become one of the most serious problems to constraint political and economic development in our province. People pay more attention to its related diseases. Toxoplasma gondii is a parasite which can live in humans and warm-blooded animals. It is a secondary infection pathogens which is common among people infected with HIV. Toxoplasma meningitis is a common disease in the brain of patients with HIV disease. It has become one of the main reasons of death in AIDS patients. HIV is a retrovirus. The CD4+ lymphocytes are destroyed after it invading in the body. It can inhibit the generation of CD4+ T lymphocytes which resulting in the number of CD4+ T lymphocyte progressive reduction when HIV infect the bone marrow stem cells. When CD4+ T lymphocytes decreased and the immune function is damaged, not only the body susceptible to Toxoplasma, but also the hidden parasite is activated in patients. Toxoplasma gondii it also can induce immunosuppression, they both promote each infection and create a vicious cycle, resulting the AIDS patients infected with the emergence of various clinical symptoms and even death.2 ObjectivesLearn the infection status of HIV accompany with Toxoplasma gondii and the relationship between CD4+ T lymphocytes and HIV viral load. It can also provide some basic information for the prevention and diagnosis of AIDS. It has important significance for secondary prevention of HIV infection with Toxoplasma gondii, prognosis and prolong the life of AIDS patients, reduce mortality and improve the quality of AIDS patients life.3 Research object3.1 Experimental group:the peripheral blood speciments from 1038 HIV samples confirmed by one step(Western blortng) in Henan province;3.2 Control group::the peripheral blood speciments from 210 normal samples confirmed by ELISA in Henan province.4 Methods4.1 Detect Toxoplasma IgG antibodyUsing enzyme-linked immunosorbent assay to detect serum samples of experimental group and control group whether or not containing Toxoplasma. By comparing the two sets of Toxoplasma infection rates, verigy whether there are differences on Toxoplasma infection rates among the two groups and the relationship between the two diseases.4.2 Toxoplasma DNA testing in bloodUsing single tube shell PCR to amplify the 529bp fragment in toxoplasma.By comparing the two sets of Toxoplasma infection rates, verigy whether there are differences on Toxoplasma infection rates among the two groups and the relationship between the two diseases.4.3 Detect CD4+ on experimental groupUsing FACSCalibur flow cytometer to exact and calculate CD3+, CD4+, CDs+and CD4+ / CD8+ T lymphocyte count proportion in HIV patients peripheral blood samples. Then compare the relationship between the CD4+T lymphocyte and Toxoplasma infection. Then the experimental group is divided into two groups. One group is HIV patients infected with toxoplasmosis, another group is HIV patients infected without toxoplasmosis. Finally compare the difference between two groups on the number of CD4+ T lymphocytes and use statistical methods to calculate the impact of Toxoplasma gondii on CD4+ T lymphocytes for HIV patients.4.4 HIV viral load testing in bloodTest HIV viral load from peripheral blood speciments in each experimental group and analysis the correlation and significant differences among the two groups on HIV viral load and verify whether toxoplasma infection has influence on HIV viral load as well as the relationship between toxoplasma infection and HIV viral load.4.5 Using statistical methods to analyze the differences of patients on HIV infection ways.Using statistical methods to analyze the relationship between the negative results of toxoplasma by PCR and infection ways of HIV.5 Results5.1 Detect Toxoplasma IgG antibodyThere are only 1013 HIV patients in experimental group except 70 HIV patients which are not collected serum samples. There are 41 positive samples and 972 negative samples for Toxoplasma antibody. The positive rate is 4.05%. There are 10 positive samples and 200 negative samples in control group which has 210 normal people. The positive rate is 4.76%. There is no significant difference in serum positive rate between experimental group and control group (X2= 0.224926 ,P=0.635312)5.2 Toxoplasma DNA testing in bloodThe positive rate is 6.358% in experimental group and the positive rate is 8.09% in control group by testing Toxoplasma DNA. There is no significant difference between them (X2=0.848702,P=0.356920)5.3 Detect CD3+, CD4+, CD8+ on experimental groupThere is no significant difference between PCR positive samples and PCR negative samples on CD3+, CD4+, CD8+ and CD4+ / CD8+ T lymphocyte count proportion in experimental group which infected with toxoplasma. There is also no significant difference on CD4+ T lymphocyte count proportion in different ranges between samples positive to toxoplasma and samples negative to toxoplasma.5.4 HIV viral load testing in bloodWe devide the HIV viral load of experimental group into four orders:<31og / mL, 3-4log / mL,4-5log / mL,> 5log / mL. There is no significant difference between the positive for toxoplasma gondii IgG antibody(X2=2.032309, P=0.565728) and the positive rate for PCR testing(X2=6.192383,P=0.102616) in four orders. HIV viral load is decreasing with the increasing of CD4+ T lymphocyte. There are negative correlation(r=-0.36) between CD4+ T lymphocyte and HIV viral load which are analyzed by using statistical software. 5.5 Analyze the correlation between the infection ways of HIV and the PCR results on toxoplasmaThe infection rate of homosexual behavior is 8.9%. The infection rate of blood transfusion is 2.8%. There is significant difference between them (X2=6.346623, P=0.01176). There is no significant difference between other infection ways of HIV and the infection of toxoplasma.6 Conclusion6.1 In this study, we use two methods which are toxoplasma IgG antibody and PCR to test the infection rate of toxoplasma in experimental group and control group. We find there is no significant difference between two groups on the infection rate of toxoplasma by using statistical software. The result of control group is almost the same with other related reports, but the result of experimental group is lower than other related reports.6.2 For HIV infected toxoplasma infection status and peripheral blood CD4+ T lymphocyte count and HIV viral load statistical analysis shows that:(1) the influence of toxoplasma on the immune systems of people with HIV is not large, the influence of AIDS on the immune system in patients is still dominant; (2) the activity of HIV virus in the body is not the body’s main risk factors of toxoplasma infection; (3) there is a negative correlation between people living with HIV peripheral blood CD4 + T lymphocyte count and viral load.6.3 By analysising the way of people HIV infection and toxoplasma PCR results showed that except the gay has a significant difference between infection and blood transfusion infection, there was no significant difference on other ways of HIV infection with toxoplasma infection, the infection rates associated with HAART antiviral treatment.6.4 MSM is one of the most main way of infection with HIV, there is a significant difference between gay infection and blood transfusion infection in such people whose CD4+ T lymphocyte count is 350 or higher in one uL...