HIV感染者合并肛门尖锐湿疣的临床特征及治疗

Clinical Characteristic and Treatment of Anus Condyloma Acuminatum with HIV Infection

目的研究尖锐湿疣合并HIV感染的临床特征和治疗方法。方法对20例尖锐湿疣合并HIV感染者的临床资料做回顾性分析。患者男性19例,女性1例;年龄19～61岁,平均(40.7±11.3)岁,术前检测CD4T淋巴细胞水平和血常规。电刀切除尖锐湿疣,应用高效抗逆转录病毒治疗和应用抗生素控制感染,及时处理并发症。结果患者的CD4T淋巴细胞为22～363(156.84±84.93)cell/μl,CD4/CD8比值为0.305±0.456,明显低于正常。4例形成巨型尖锐湿疣,2例发生癌变。手术切除后3个月内有4例复发,12个月内有6例复发。结论尖锐湿疣合并HIV感染患者免疫力低下,容易形成巨型尖锐湿疣,容易发生癌变。电刀彻底切除病变结合应用抗逆转录病毒药物,可以取得较好的疗效,降低复发率。

Objective To investigate the clinical characteristic and treatment method for condyloma acuminatum with HIV Infection. Methods Retrospective analysis for 20 cases of condyloma acuminatum with HIV Infection patients（ male 19 and fe- male 1 ,aged 19 -61 years old） was carried out. All patients had pre-operative detection of immune function. Electrocdagulation was used to remove condyloma acuminatum;the highly active antiretroviral therapy and conventional application of antibiotics to prevent infection and promptly treatment of complications. Results The patient＇ s preoperative CIM T lymphocyte count was 22 - 336 celL/l^l（ mean ： 156.84, SD ： 84.93 ）, The range of preoperative CIM/CD8 was 0. 056 - 2. 014 （ mean ： 0. 305, SD ： 0.456）, far lower than general populations. There were 4 cases with great condyloma acuminatum and 2 cases were canceration. The condyloma acuminatum recrudesced in 4 within three months and 6 cases within 12 months after the operation. Conclusion The condyloma acuminatum patients with HIV infection generally had immunodeficiency and had a tendency to develop great con- dyloma acuminatum and Canceration. The condyloma acuminatum resection by electrocoagulation combined with highly active an- tiretroviral therapy can get a better effect and reduce the recurrence rate.