【摘要】 目的 探讨综合性医院内获得性免疫缺陷综合征（acquired immune deficiency syndrome，AIDS）患者的肺部表现及其特征。 方法 回顾性分析2006年2月－2009年12月收治的58例AIDS患者肺部病变的临床资料。 结果 58例患者中男47例，女11例，男女比例为4.27∶1；年龄6~78岁，平均43岁，其中lt;50岁者36例，占62.1%，gt;50岁22例，占37.9%。肺部表现是AIDS患者入住综合性医院的常见临床表现，居各种临床表现的首位（占55.2%）。主要有弥漫性肺部疾病和肺结核，分别是21例（36.2%）和23例（39.7%），收治的主要科室是呼吸内科38例（65.5%）和传染科12例（20.7%）；常见的临床症状有发热、咳嗽、活动后气促或呼吸困难；其肺部影像学表现多样，有毛玻璃样变、弥漫性结节影、斑片影、肺内块影或肺内空洞、纤维条索影或伴胸水；其常见伴随症状有口腔溃疡真菌、腹泻或其他消化道症状，及其皮疹、贫血、神经系统症状等；同时也有部分患者合并乙型肝炎病毒/丙型肝炎病毒/梅毒等混合感染。 结论 AIDS的肺部病变是综合性医院住院AIDS患者的主要表现，提高呼吸科医师对AIDS患者肺部表现的认识将有利于AIDS的临床防治。【Abstract】 Objective To investigate the clinical characteristics of acquired immune deficiency syndrome (AIDS) with pulmonary diseases in comprehensive hospitals. Methods The clinical data of 58 cases of AIDS with pulmonary diseases admitted in our hospital from 2006 to 2009 were analysed retrospectively. Results Among the patients, there were 47 males and 11 females, and the proportion of the number of males to females was 4.27∶1. Their age ranged from 6 to 78 years old, averaging at 43. Thirty-six patients (62.07%) were under 50 years old; and there were 22 patients (37.93%) aged 50 or above. The pulmonary expression was common in AIDS patients admitted into comprehensive hospitals, occupying the first place in various clinical manifestatiosn (55.24%). Pulmonary expressions of AIDS were mainly diffuse pulmonary diseases and pulmonary tuberculosis, which had 21 (36.21%) and 23 (39.66%) cases respectively. Chief treating departments were Department of Respiratory Medicine (65.52%) and Department of Infective Diseases (20.69%). Its common symptoms included fever, cough, shortness of breath after activities or dyspnea; Its pulmonary image had various manifestations including ground-glass opacity (GGO), diffuse nodal shadow, spot and thin piece shadow, pulmonary chunk shadow or cavity, fibre twigs shadow or/and hydrothorax; Its common combined symptoms included oral cavity ulcer fungus infection, diarrhoea or other digestive tract symptoms, and erythra, anemia, and nervus system symptoms, etc. There were still some other cases of combined viral hepatitis type B, type C, or syphilis. Conclusion Pulmonary diseases of AIDS are the main expressions of patients with AIDS in comprehensive hospitals. It will be beneficial to clinical prophylaxis and treatment of AIDS to heighten the knowledge of respiratory physicians on pulmonary expressions of patients with AIDS.
In recent years, the incidence rate of ischemic stroke in people living with HIV/AIDS (PLWHA) is increasing, attracting wide attention from scholars at home and abroad. In addition to traditional risk factors of stroke, the secondary ischemic stroke in PLWHA is also affected by HIV infection. This study reviews the incidence rate and risk factors of secondary ischemic stroke in PLWHA, in order to provide a theoretical basis for preventing and reducing the incidence of ischemic stroke in PLWHA.
Objective To analyze the clinical epidemiological characteristics and trends of newly reported human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Panzhihua Central Hospital, and provide a scientific basis for general hospitals to formulate precise prevention and control measures. Methods The information such as gender, age, ethnicity, and transmission route of the newly reported HIV/AIDS patients in Panzhihua Central Hospital from 2010 to 2019 was retrospectively analyzed. Results A total of 551545 patients were screened for HIV in Panzhihua Central Hospital between 2010 and 2019, among them, 1091 patients were confirmed as HIV infection finally, with a confirmed positive rate of 0.20%. The number of confirmed cases and the positive rate continued to increase from 2010 to 2017, and obviously declined after 2018. The male to female ratio of newly diagnosed HIV/AIDS patients was 2.86∶1, and the 31-45 years old middle-aged and young adults were the majority (31.16%). The majority of HIV/AIDS patients were identified as married (58.02%), primary school education (40.70%), farmers (46.38%), and Han nationality (79.84%). Yi nationality also had a high proportion (18.52%) with an increasing trend year by year (χ2trend=8.131, P=0.004). Yi nationality patients were mainly from Liangshan Yi Autonomous Prefecture (58.42%). A high proportion of 50.32% of patients came from other cities, among them, the proportion of patients from Liangshan Yi Autonomous Prefecture increased over time (χ2trend=13.608, P<0.001). The transmission routes were mainly through heterosexual sex (90.93%), with an upward tendency of proportion (χ2trend=22.137, P<0.001), and transmission through drug abuse was following (4.49%), with an downward tendency of the proportion (χ2trend=11.758, P=0.001). Significant differences in transmission routes were observed between males and females (P=0.020), and between Han nationality and Yi nationality (P<0.001). Conclusion The newly repored HIV/AIDS patients in Panzhihua Central Hospital have a high proportion of minority nationality, and heterosexual transmission is the main transmission route.
ObjectiveTo investigate the clinical manifestations of acquired immunodeficiency syndrome(AIDS) patients with initial-stage cytomegalovirus (CMV) retinitis (CMVR).MethodsRetrospective case series study. From July 2017 to November 2019, 21 patients with 22 eyes of AIDS combined with CMVR in the initial stage of AIDS and CMVR diagnosed in the eye examination in the study. Among them, there were 19 males with 19 eyes and 2 females with 3 eyes; the average age was 34.3±9.6 years. The average CD4+ T lymphocyte count of patients was 26.1±23.2/μl. Routine fundus screening revealed 17 cases, and the contralateral eye disease was found in 4 cases. There were 13 cases of CMVR in both eyes (61.9%, 13/21). Among them, both eyes were in the initial stage of CMVR, and the contralateral eyes were in the early stage of CMVR in 12 cases. The contralateral eye included 2 cases of human immunodeficiency virus-related retinal microangiopathy, 1 case of optic disc edema, and 5 cases of no obvious abnormality on fundus examination. All patients underwent slit lamp microscopy and ultra-wide-angle fundus photography examination. At the same time, 18 eyes underwent optical coherence tomography (OCT). Blood CMV-DNA detection was performed in 17 cases within 1 week before the first diagnosis; aqueous CMV-DNA detection was performed in 7 eyes within 1 week after the first diagnosis. Within 1 week after the fundus examination, 8 eyes of 8 cases and 8 eyes of 7 cases were received and not received systemic anti-CMV treatment; the treatment status was unknown in 6 cases and 6 eyes. After treatment, 18 eyes of 17 cases were followed up. The follow-up time was 0.5-28 months.ResultsThere were no obvious abnormalities in the anterior segment examination of all the affected eyes; the vitreous body was transparent. The fundus lesions were less than 1 optic disc diameter (DD), and they were white granular, clustered, with blurred edges. Among them, there were granular satellite lesions around the lesion in 18 eyes (81.8%, 18/22). The lesions were located in 19 eyes (86.4%, 19/22) in zone 2, 1 eye in zone 1 and 2 (4.5%, 1/22), and 2 eyes in zone 3 (9.1%, 2/22). In 18 eyes that underwent OCT examination, 12 eyes failed to obtain image data because the lesion was not in the conventional scanning range; the other 6 eyes showed the inner or full retina thickened or atrophy depression, structural destruction, accompanied by local vitreous punctate strong reflection. Among the 17 patients who underwent blood CMV-DNA testing, 1 (5.9%, 1/17) and 16 (94.1%, 16/17) cases were CMV-DNA negative and positive, respectively. The 7 eyes that underwent the CMV-DNA test of aqueous humor were all negative. Among the 18 eyes who were followed up, the lesions did not expand, and gradually subsided and absorbed in 4 eyes (22.2%, 4/18); the varying degrees of lesion enlargement in 14 eyes (77.8%, 14/18).ConclusionThe patients with AIDS and CMVR at the initial stage have no obvious ocular symptoms; the fundus shows white granular lesions less than 1 DD with blurred edges.
Objective To analyze the clinical data of monkeypox (mpox) cases in Chengdu, to investigate the clinical characteristics of patients with mpox complicated with human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS), and provide reference for clinical diagnosis and treatment. Methods Mpox patients admitted to Public Health Clinical Center of Chengdu between June 29 and August 8, 2023 were continuously included. Patients were divided into an observation group and a control group based on whether they were complicated with HIV/AIDS. The clinical characteristics of two groups of patients were observed and compared. Results A total of 56 patients were included, all of whom were male; Age range from 19 to 51 years old, with an average of (31.6±5.9) years old; There were 23 cases in the observation group and 33 cases in the control group. Except for age, perianal lesions with infection, number of rashes, diarrhea, CD4+ lymphocyte count, CD4/CD8 ratio, syphilis, chest CT abnormalities, rash duration, and length of hospital stay (P<0.05), there was no statistically significant difference in epidemiological data, clinical features, auxiliary examinations, treatment, and intensive care unit admission between the two groups of patients (P>0.05). There was a statistically significant difference between the Ct values of throat swab nucleic acid and blister fluid nucleic acid in the total population [(30.1±4.4) vs. (23.4±3.8); t=5.462, P<0.001]. Conclusions Mpox patients complicated with HIV/AIDS are prone to persistent, diverse, and severe lesions due to relatively lower CD4+ lymphocyte counts. Therefore, it is necessary to actively provide symptomatic treatment and prevent complications for patients.
Objective To observe the fundus characteristics of human immunodeficiency virus with acquired immune deficiency (HIV/AIDS). Methods A total of 1041 HIV/AIDS patients were enrolled in this study. The patients included 882 males (88.70%) and 159 females (11.30%). The patientsprime; ages ranged from 12 to 73 years, with a mean age of 41 years. The median time of HIV/AIDS diagnosis was 12 months, which ranged from one month to 10 years. HIV infection was acquired through sexual contact, intravenous drug use, blood transfusion or mother-to-child transmission in 475 patients (45.63%), 508 patients (48.80%), 44 patients (4.25%) and 14 patients (1.34%), respectively. Ocular examinations (vision acuity, slit lamp microscope and fundus examination) were performed on recruited patients with HIV/AIDS. Additional exams (intraocular pressure, fundus photography and fundus fluorescein angiography) were done if abnormal ocular fundus was found. The ocular manifestations were diagnosed according to clinic reference. Results Ocular manifestations of HIV/AIDS were detected in 247 patients (23.73%). Of 247 patients, the most common ocular manifestation was HIV retinopathy, which was present in 132 patients (53.44%); cytomegalovirus retinitis (CMVR) was second place, affecting 70 participants (28.34%). Clinic findings of HIV retinopathy included retina microaneurysm, hemorrhage along the blood vessel with cotton-wool spots, while irregular dry edge, granular appearing border, were present in CMVR, and the optic nerve may be affected. Fluorescein angiogram of HIV retinopathy demonstrated that hemorrhage was shown as sheltered fluorescence, with b fluorescence without leakage in center of hemorrhage. Fluorescein angiogram of CMVR demonstrated significant hemorrhage appearing as sheltered fluorescence with leakage and/or transparent fluorescence. The optic disk and lesioned area were stained with fluorescence. Conclusions There are various HIV/AIDS related ocular manifestation. HIV retinopathy and CMVR are common ocular manifestations. The main clinical findings of HIV retinopathy are hemorrhage and/or cotton-wool spots, while irregular granular appearing edges and hemorrhage were observed in CMVR.