HIV/AIDS患者伴尖锐湿疣的治疗

Effect of carbon dioxide laser combined with imiquimod cream in the treatment of condyloma acuminatum in HIV/AIDS patients

目的观察CO2激光联合咪喹莫特乳膏治疗不同CD4+T淋巴细胞水平的HIV/AIDS患者伴尖锐湿疣的疗效。方法采用病例对照研究,普通尖锐湿疣患者为对照组、HIV/AIDS患者且CD4+T淋巴细胞计数在200 cells/μL以上为试验A组、HIV/AIDS患者且CD4+T淋巴细胞计数在200 cells/μL以下者为试验B组。3组患者均给予CO2激光联合咪喹莫特乳膏治疗。结果 CO2激光联合咪喹莫特乳膏治疗HIV/AIDS患者伴尖锐湿疣对试验A组疗效较试验B组好。试验A组患者治疗时间不低于12周,试验B组患者治疗时间大于12周;3组患者治愈率和复发率差异有统计学意义。结论对于CD4+T淋巴细胞小于200 cells/μL的HIV/AIDS患者尽快进行高效抗反转录病毒治疗(HAART),可待CD4+T淋巴细胞上升至大于200 cells/μL时,再进行治疗,可以降低尖锐湿疣的复发率,减少治疗次数。该类患者进行HAART是必要的。

Objective To observe the effect of carbon dioxide laser combined with imiquimod cream in treating condyloma acuminatum in HIV/AIDS patients with different levels of CD4＋ T lymphocyte.Methods The design was case control study.The patients with condyloma acuminatum alone were treated as control group.The patients with both HIV/AIDS and condyloma acuminatum and CD4＋ T lymphocyte 200 cells/μL were treated as group A.The patients with both HIV/AIDS with condyloma and CD4＋ T lymphocyte 200 cells/μL were treated as group B.All patients were treated by carbon dioxide laser and imiquimod cream.Results Group A showed fewer recurrences of warts than group B.The difference was significant（P 0.05）.Similar result was observed in the cure rate.The difference between groups was also significant（P 0.05）.Conclusions Carbon dioxide laser combined with imiquimod cream was more effective in treating condyloma acuminatum and HIV/AIDS complicated with condyloma acuminatum when CD4＋T lymphocyte level 200 cells/μL compared with the patients with CD4＋T lymphocyte level 200 cells/μL.Treatment duration should be no shorter than 12 weeks in HIV/AIDS patients complicated with condyloma acuminatum and CD4＋T lymphocyte level 200 cells/μL.When CD4＋T lymphocyte level 200 cells/μL,the treatment duration should be longer than 12 weeks and HAART should be started early.Carbon dioxide laser and imiquimod cream treatment may be appropriate when CD4＋T lymphocyte level recovered to 200 cells/μL.For the patients with both HIV/AIDS and condyloma acuminatum,carbon dioxide laser combined with imiquimod cream and HAART may be necessary when their CD4＋T lymphocyte 200 cells/μL.