老年HIV/AIDS住院患者48例流行病学及临床特征分析

The Epidemiological and Clinical Characteristics of 48 older HIV/AIDS patients in Chongqing

目的探讨分析老年艾滋病(AIDS)病人的流行病学、临床特点以及治疗经验。方法回顾性研究2003-2009年重庆市公共卫生医疗救治中心收治的年龄在50岁及以上的老年艾滋病病毒(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 48例病人中,男42例,女6例;年龄平均(61.92±9.16)岁(50～92岁);38例经过性途径感染,2例经过同性性行为传播,另有2例经吸毒感染,6例不详。CD4+T淋巴细胞1～415/mm3,平均(83.33±105.00)/mm3;CD8+T淋巴细胞67～1741/mm3,平均(612.02±389.78)/mm3;病毒载量检测结果 :4例<50拷贝/mL,23例平均(5.87±0.86)Log10拷贝/mL(4.36～7.73Log10拷贝/mL)。机会性感染中,细菌性肺炎34例(70.83%),口腔念珠菌感染26例(54.17%),结核病15例(31.25%),耶氏肺孢子菌肺炎(PCP)感染14例(29.17%)。48例中有18例进行了抗病毒治疗。结论近年来,老年人群中HIV/AIDS问题不断凸现;其不易及时检出,机会性感染严重、合并症复杂、治疗效果延迟等现象是AIDS防控的棘手问题,应引起高度重视。

Objective To explore and analyze the characteristics of epidemiology,clinical features and summarize the treatment experience.Methods A retrospective study on the clinical data of 48 cases of geriatric people living with HIV/AIDS（PLWHA）hospitalized from 2003 to 2009 was conducted.The data included in demographic datum,immunological datum,virological datum,diagnosis of opportunistic infection and highly active antiretroviral therapy（HAART）treatment.Results ①Forty-two male patients and 6 female patients were aged 50～92 with an average age of（61.92±9.16）.Thirty-eight of them were infected by sexual contacts and 2 infected by homosexual behavior.Other 2 cases infected by taking drugs.②T-lymphocyte subsets：CD＋4 T-lymphocyte count was 1～415/mm^3,with a mean of 83.33 ±105.00/mm^3.CD8^＋ T-lymphocyte count was 67～1741/mm^3,with a mean of（612.02±389.78）/mm^3.③HIV-RNA viral load was below 50 copies/mL（LDL）in 4 cases and ranged from 4.36～7.73 Log10 copies/mL,with a mean of（5.87±0.86）copies/mL in cases.④As for spectrum of opportunistic infection,Pneumonia infection accounted for 70.83%;thrush 54.17%,tuberculosis 31.25%;PCP infection 29.17%;18 cases were given the antiretroviral therapy（HAART）.Conclusion In recent years,the HIV/AIDS problems among older population have been increased obviously.The characterisic of being not easy to detection,serious opportunity infection,complex complication and the detention of treatment result are the barriers of HIV/AIDS control.