新发传染病电子杂志2026，Vol.11Issue(4)：36-43,8.DOI:10.19871/j.cnki.xfcrbzz.2026.04.006
HIV感染/AIDS患者认知障碍影响因素及CD4+T淋巴细胞计数水平的预测价值分析
Analysis of factors influencing cognitive impairment and the predictive value of CD4+T lymphocyte count in patients with HIV/AIDS
摘要
Abstract
Objective To investigate factors associated with cognitive impairment in patients with HIV/AIDS and to evaluate the discriminative performance of CD4+T lymphocyte count for cognitive impairment,thereby providing evidence for the early clinical identification of individuals at high risk of cognitive impairment.Method A cross-sectional study was conducted.A total of 71 patients with HIV/AIDS who attended Chengdu Public Health Clinical Medical Center between January 1,2024 and November 30,2025 were enrolled.According to cognitive function assessment results,the patients were divided into a cognitively normal group(n=43)and a cognitive impairment group(n=28).General clinical data,sociodemographic characteristics,and laboratory indicators were collected from the hospital electronic medical record system,and quantitative brain structural imaging parameters were also obtained.Univariate analysis was performed to compare differences between the two groups.Based on the results of univariate analysis,statistical independence of variables,and clinical accessibility,a binary logistic regression model was constructed to identify independent factors associated with cognitive impairment.Receiver operating characteristic(ROC)curve analysis was further performed for significant variables to evaluate their discriminative performance.Result Univariate analysis showed that CD3+T lymphocyte count and CD4+T lymphocyte count were significantly lower in the cognitive impairment group than in the cognitively normal group(t=2.128,P=0.037;t=6.044,P＜0.01,respectively).Marital/partner status differed significantly between the two groups(χ2=6.303,P=0.012).Temporal lobe gray matter volume tended to be lower in the cognitive impairment group,and the difference was statistically significant in the uncorrected between-group comparison(t=2.114,P=0.038);however,the difference was no longer significant after false discovery rate correction.Binary logistic regression analysis showed that CD4+T lymphocyte count(OR=0.987,95%CI:0.980-0.994,P＜0.001)and marital/partner status(single vs.non-single:OR=5.702,95%CI:1.193-27.251,P=0.029)were significantly associated with cognitive impairment.ROC curve analysis indicated that CD4+T lymphocyte count had good discriminative performance for cognitive impairment,with an area under the curve of 0.886(95%CI:0.812-0.961,P＜0.001).At a cutoff value of approximately 260 cells/μl,the sensitivity was 93.0%and the specificity was 67.9%.Conclusion Decreased CD4+T lymphocyte count and being single were the main factors associated with cognitive impairment in patients with HIV/AIDS.CD4+T lymphocyte count demonstrated good screening value for cognitive impairment and may serve as a reference indicator for early identification of high-risk patients and follow-up management.关键词
人类免疫缺陷病毒/获得性免疫缺陷综合征/认知障碍/CD4+T淋巴细胞计数/脑结构磁共振成像/预测价值Key words
Human immunodeficiency virus/Acquired immunodeficiency syndrome/Cognitive impairment/CD4+T lymphocyte count/Structural magnetic resonance imaging of the brain/Predictive value分类
医药卫生引用本文复制引用
熊磊,熊维,戈杨,王印,傅思琪,张娜,侯可可,张淑颖,李桃,何江林,卢晓希,万婷,谢利秋,杨佳,高月琴..HIV感染/AIDS患者认知障碍影响因素及CD4+T淋巴细胞计数水平的预测价值分析[J].新发传染病电子杂志,2026,11(4):36-43,8.基金项目
1.四川省医学会青年创新项目(Q2024056) （Q2024056）
2.成都市科技局技术创新研发项目(2024-YF05-01215-SN) （2024-YF05-01215-SN）
3.成都市医学科研课题项目(2025122、2025561) （2025122、2025561）
