老年HIV感染者/AIDS病人临床特征的研究

Clinical manifestations of elderly people living with HIV/AIDS

目的探讨分析老年艾滋病（AIDS）病人的临床特点以及治疗经验。方法回顾性研究1999-2007年收治的、年龄超过60岁的、老年艾滋病病毒（HIV）感染者/AIDS病人的临床数据资料,包括人口统计学、免疫学指标、病毒学指标、机会性疾病及HIV/AIDS诊断情况,以及老年抗病毒治疗情况等。结果13例病人中,男性10例,女性3例;年龄平均63.6岁（61～71岁）;4例经过性传播途径感染,2例经过输血传播,7例不详。CD4^＋T淋巴细胞26-1 395/μl,平均262/μl;CD8^＋T淋巴细胞484-7 591/μl,平均1 395/μl;病毒载量1例检测结果是〈50拷贝/ml,4例为3.43-5.46Log10拷贝/ml,平均4.44 Log10拷贝/ml。机会性感染中,真菌感染为40%,结核30%,CMV感染20%,消耗综合征20%。13例中7例进行了抗病毒治疗。结论老年人感染HIV/AIDS可以造成各种机会性疾病。老年HIV感染者/AIDS病人需要进行联合的抗逆转录病毒治疗。

Objective To explore and analyze specific clinical manifestations of elderly people living with HIV/AIDS （PLWHA）and experience for their treatment. Methods A retrospectively study on the clinical data of 13 cases of geriatric PLWHA hospitalized from 1999 to 2007 was conducted. The data included demographic status,immunological and virological indices, diagnosis of opportunistic diseases and HIV/AIDS and outcomes of HAART. Results 1）Ten male cases and three female cases were aged 61-71 years with an average age of 63.6 years. Four of them were infected by sexual contacts and two infected by blood transfusions.2）T-lymphocyte subsets： CD4 T-lymphocyte count was 26-1395/ul, with a mean of 262/ul;CD8 T-lymphocyte count was 484-7591/ul, with a mean of 262/ul.3）HIV-RNA viral load was below 50eopies/ml（LDL） in one case and ranged from 3.43-5.46Log10 copoes/ml, with a mean of 4.44 copies/ml in four cases.4）As for spectrum of opportunistic diseases, fungal infection accounted for 40 % ;TB-30 % ;CMV infection-20 % ; wasting syndrome-20 % . 5 ）Seven cases received highly active antiretroviral therapy （HAART） . Conclusion Geriatric PLWHA may be complicated with various opportunistic diseases and so should be accessible to. HAART.