以带状疱疹为首发症状的HIV感染者/艾滋病患者40例临床分析

Clinical Analysis of 40 Cases HIV /AIDS with Herpes Zoster as the Initial Symptom

目的探讨以带状疱疹为首发表现的HIV感染者／艾滋病患者的临床特点和治疗情况。方法对2010年7月-2013年12月间在本科诊治的40例以带状疱疹为首发表现的HIV感染者／艾滋病患者的临床资料进行分析。结果40例患者中，男36例，女4例；年龄20～50岁34例，51～80岁5例，83岁1例。职业：经商11例、无业21例、其他8例。有多性伴或嫖娼史者31例，同性恋1例，静脉吸毒1例，感染途径不详7例。合并尖锐湿疣2例、隐性梅毒4例、肺结核1例；同时合并尖锐湿疣、隐性梅毒2例；同时合并铜绿假单胞菌肺炎及艾滋病脑病1例。40例患者的带状疱疹经常规治疗后36例治愈，2例伴后遗神经痛3～6个月，1例不详，1例死亡。结论以带状疱疹为首发症状的HIV感染者或艾滋病患者以经商或无业的男性青壮年多见，感染途径以性传播为主；本病虽皮疹广泛、疼痛剧烈，但多数患者疗效较好。临床医师在接诊患者时应常规进行传染病筛查，做好职业防护，避免漏诊和医源性传播。

Objective To study clinic characteristics and treatment of HIV/AIDS combined with herpes zoster as the initial symptom. Methods Analyze clinical data of 40 patients with HIV-infected or AIDS whose first symp- tom was herpes zoster, diagnosed and treated during the period from July 2010 to December 2013. Results Fourty cases were consisted of 36 males and 4 females. Age ： 34 cases were aged 20 - 50 yrs, 5 cases aged 51 - 80 yrs,and 1 case aged at 83. Oeupation： 11 cases engaged in business, 21 were jobless and 8 cases took other jobs. Thirty-one cases had muhiple sex partners or the history of prostitution. One case was homo- sexual. One had experience of intravenous drug use. Seven cases were unidentified. Two cases were con- comitantly affected with condyloma acuminatum,4 cases with recessive syphilis, 1 case with pulmonary tuber- culosis ,2 cases with condyloma acuminatum and recessive syphilis, and 1 case with pseudomonas aeruginosa pneumonia and AIDS encephalopathy. For the herpes zoster lesions, 36 cases were cured by routine treat- ment, 2 with postherpetic neuralgia in 3 months to half a year, 1 case with loss of followup, and 1 case died. Conclusion Most of HIV/AIDS presented with herpes zoster as the initial symptom are young men with business or joblessness. The major route of infection is sex transmission. Although the rash area is large and with severe pain, the majority of patients have good curative effect. Clinicians should routinely screen patients with infectious diseases in the reception, take caution with well occupational protection, avoid missed diagnosis and iatrogenic infection.