两例获得性免疫缺陷综合征合并新型冠状病毒感染者抗病毒治疗并文献复习

Antiviral treatment of two cases with human immunodeficiency virus complicated with severe acute respiratory syndrome coronavirus 2 co-infection and literatures review

目的提高获得性免疫缺陷综合征(AIDS)合并新型冠状病毒(SARS-CoV-2)感染抗病毒治疗的认识。方法分析2023年2月汕头市中心医院收治的2例AIDS患者合并SARS-CoV-2感染的诊治过程并结合相关文献复习。结果2例AIDS患者均因呼吸道感染症状来院就诊,均合并口腔念珠菌感染,胸部CT影像学提示双肺多发磨玻璃样改变,入院后查SARS-CoV-2核酸阳性,使用奈玛特韦利托那韦抗病毒、抗感染等对症支持治疗后,SARS-CoV-2核酸转阴时间分别为抗病毒治疗后第4天、第3天,呼吸道症状改善,均好转出院;出院1个月后随访,2例患者均无发热,仍有咳嗽,但较前改善,伴疲乏症状。结论AIDS合并SARS-CoV-2感染者仍以下呼吸道感染为主要临床表现;CD4+T淋巴细胞水平可能不影响患者转归;积极抗SARS-CoV-2治疗可改善患者预后。

Objetctive To improve the understanding of antiviral treatment for human immunodefeciency virus(HIV)complicated with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)co-infection.Method The diagnosis and treatment process of 2 patients with HIV/SARS-CoV-2 co-infection admitted to Shantou Central Hospital on February 2023 were analyzed and relevant literature were reviewed.Results Two HIV infected patients presented with respiratory symptoms were admitted to our hospital.Both patients had oral candidiasis and chest CT imaging showed multiple ground-glass opacities in lungs.After admission,they were detected positive for SARS-CoV-2 nucleic acid.They received antiviral and anti-infection treatments such as Nirmatrelvir Tablets/Ritonavir Tablets.SARS-CoV-2 nucleic acid turned negative in two patients on the 4th days and 3rd day after using Nirmatrelvir Tablets/Ritonavir Tablets.Their respiratory symptoms improved and they were discharged.One month after discharge,the patients did not have a fever but still had coughing,although both improved compared to before.They also experienced fatigue symptoms during the follow-up visits.Conclusions HIV/SARS-CoV-2 co-infected patients still mainly presents lower respiratory tract infections as the primary clinical manifestation.CD4+T lymphocyte levels may not affect the outcomes of HIV/SARS-CoV-2 co-infection.However,antiviral treatments for SARS-CoV-2 can improve the prognosis of HIV/SARS-CoV-2 co-infection,which should be paid more attention.