【摘要】 目的 观察人类免疫缺陷病毒（HIV）感染后对人体各个系统的影响，为其诊断和治疗提供经验。 方法 回顾性分析2005年1月—2010年6月于华西医院确诊为HIV感染13例患者的临床表现和相关实验室指标。 结果 13例HIV感染患者均合并其他感染，以结核病最为常见；除有T淋巴细胞异常外，多数患者可合并出现血液学异常，包括贫血、白细胞和血小板降低；生化异常，包括球蛋白升高、白蛋白降低；HIV感染患者可合并出现风湿病症状和免疫学异常。 结论 HIV感染患者临床表现复杂多样，可合并出现多种感染和风湿病症状，血液学及免疫学异常也比较常见。【Abstract】 Objective To observe the impact of human immunodeficiency virus (HIV) on each system of human body after its infection, in order to provide experiences for diagnosis and treatment of this disease. Methods The clinical manifestations and related laboratory results of 13 inpatients treated in West China Hospital of Sichuan University from January 2005 to June 2010 were reviewed retrospectively. Results The incidence of infection in these patients was 100% with tuberculosis as the most common infection. Apart from the abnormality of T lymphocytes, most patients had a change of hematology and biochemistry, including anemia, depression of leucocytes and platelets, hyperglobulinemia and hypoproteinemia; HIV-infected patients may also presented with rheumatic manifestations or abnormality in the immune system. Conclusion The clinical manifestations of patients with AIDS are complicated. Many kinds of infections and rheumatic manifestations may merge and the change in hematology and immunology is common.
Objective To evaluate the relation of human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) loads in cerebrospinal fluid with central neurological diseases. Methods The inpatients with HIV-1 infection diagnosed by Public Health Clinical Center of Chengdu between January 1st, 2015 and March 1st, 2018 were retrospectively included. The included patients were divided into central neurological disease group and non-central neurological disease group, and high viral load group and low viral load group. The demographic data, CD4+ T lymphocyte count, routine detection of cerebrospinal fluid, HIV RNA load in cerebrospinal fluid and plasma of patients with and without central neurological diseases were observed and compared.Multiple logistic regression analysis was used to identify risk factors for central neurological diseases. Results A total of 367 patients were included. In the central neurological disease group, 210 cases (57.22%) were complicated with central neurological diseases, and cryptococcus infection was the most. Compared with the non-central neurological disease group, the increase rate of cerebrospinal fluid cell counts, cerebrospinal fluid cell counts, cerebrospinal fluid HIV RNA positivity and cerebrospinal fluid HIV RNA load were higher in the central neurological disease group (P<0.05). Logistic regression analysis showed that HIV RNA load in cerebrospinal fluid≥100 000 copies/mL and CD4+ T lymphocyte count<200 cells/mm3 were risk factors for central neurological diseases. Conclusion Cerebrospinal fluid HIV RNA load≥100 000 copies/mL is an independent risk factor for HIV/AIDS patients with central neurological diseases and clinical treatment should take this factor into consideration to reasonably optimize the selection of antiretroviral therapy.
目的:进一步认识获得性免疫缺陷综合征（AIDS）并发机会感染的临床特点，提高临床诊断水平，减少误诊。方法:回顾性分析我院85例住院的AIDS患者的临床资料。包括临床表现、常见的机会感染、实验室检查异常情况及机会感染的确诊时间等情况。结果:本组资料中发生机会感染患者主要为青壮年男性，发病后误诊率为70%，大多经两家医院就诊后确诊。60%以上患者首诊于非感染科。临床表现主要有发热、咳嗽、腹泻、消瘦、皮疹、贫血等症状和体征。肺部感染35例（14%），肺结核12例（14%），乙型肝炎9例（10%），丙型肝炎10例（11%），梅毒 7例（8%），耶氏肺孢子菌肺炎（PCP）15例（17%），败血症1例 （1%）。结论:HIV机会感染呈多器官受累，临床表现复杂，不具特异性。临床应提高认识，减少误诊。
ObjectiveTo compare the value of CURB-65 score and expanded CURB-65 score in evaluating prognosis of pneumonia in non-HIV infected patient and HIV infected patient.MethodsThe study included 206 hospitalized pneumonia patients without HIV infection and 299 pneumonia patients with HIV infection. According to their clinical prognosis within 4 weeks of treatment, they were divided into a deterioration group and an improvement group. The basic situation and the differences of clinical indicators between the two groups were compared. The predictive value of CURB-65 score and expanded CURB-65 score for clinical prognosis of pneumonia in non-HIV infected patients and HIV infected patients was compared by using receiver operator characteristic (ROC) curve.ResultsFor the pneumonia patients without HIV infection, the area under ROC curve (AUC) of CURB-65 score and expanded CURB-65 score were 0.862 and 0.848, respectively. There was no significant difference in AUC between CURB-65 score and expanded CURB-65 score (Z=0.661, P=0.5084). The Youden indexes of CURB-65 score and expanded CURB-65 score were 60.11% and 54.92%, respectively. For the pneumonia patients with HIV infection, the AUC of CURB-65 score and expanded CURB-65 score were 0.588 and 0.634, respectively. There was no significant difference between them (Z=1.416, P=0.1567). The Youden index of the two scores was 19.53% and 20.52%, respectively.ConclusionsThe CURB-65 score and expanded CURB-65 score can effectively evaluate the clinical prognosis of pneumonia in non-HIV infected patients, but their predicted values are limited in evaluating the prognosis of pneumonia in HIV infected patients.
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.
Human immunodeficiency virus (HIV)-1 p24 antigen is one of the earliest proteins appearing after HIV infection. It can be used as a diagnostic marker to shorten the detection “window period” to about 14 days. It is of vital importance in the process of early diagnosis and antiviral therapy monitoring. This review briefly describes the basic structure and clinical significance of detection of HIV-1 p24 antigen, focusing on the current domestic and foreign researches on the biosensors of HIV-1 p24 antigen based on new nanomaterials, in order to provide a reference for developing novel detection technology.
Objective To investigates the awareness of medical staff on prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) . Methods Between April and July 2014, health workers from towns and cities of Liangshan Prefecture participated in the class of prevention of HIV PMTCT for key areas in Sichuan province. Those participants, together with some other health workers from the same area whose daily work was related to prevention of PMTCT, were selected as the study subjects. PMTCT prevention knowledge survey questionnaire was given out for the investigation, and chi-square test was used for statistical analysis. Results We retrieved altogether 447 (out of 450) valid questionnaires. Of all the respondents, 94.18% were aware of proper time for HIV antibody testing and routes of transmission in the perinatal period, 95.30% knew the strategy of applying as early as possible antiviral drugs during pregnancy, and 86.58% learned to know when to give the first dose to the newborns and avoidance of breast-feeding. However, the awareness of relevant applied knowledge was relatively low. The total awareness rate of medical workers from women and children’s hospitals were significantly better than that of medical workers from general hospitals (P<0.05), and differences of the awareness depended on different specialties, professional titles and working age (P<0.05). Conclusions The majority of medical personnel in the surveyed area have grasped basic knowledge of PMTCT of HIV, but the ability of applying relevant knowledge precisely, promptly and standardly in daily practices needs to be improved. We recommend that, in addition to strengthening routine training on knowledge of PMTCT of HIV, the mastering and practice of key technical intervention strategies should be followed up and evaluated, especially for those from general hospitals. And it is also important to give training and after-training assessment based on different specialties.