成都市猴痘合并人类免疫缺陷病毒感染/获得性免疫缺陷综合征病例临床特征分析

Clinical characteristics of monkeypox complicated with human immunodeficiency virus infection/acquired immunodeficiency syndrome in Chengdu

目的对成都市收治猴痘病例临床资料进行分析,了解猴痘合并人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染/获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者临床特征,为临床诊疗提供参考。方法连续性纳入2023年6月29日—8月8日收入成都市公共卫生临床医疗中心的猴痘患者。按照是否合并HIV感染/AIDS分为观察组和对照组。观察比较两组人群临床特征。结果共收治患者56例,均为男性;年龄19~51岁,平均(31.6±5.9)岁;观察组23例,对照组33例。除年龄、肛周病变伴感染、皮疹数量、腹泻、CD4+淋巴细胞计数、CD4/CD8比值、梅毒、胸部CT异常、皮疹持续时间、住院天数外(P<0.05),两组患者的流行病学资料、临床特征、辅助检查、治疗和入住重症监护病房情况比较差异均无统计学意义(P>0.05)。总人群咽拭子核酸Ct值与疱液核酸Ct值比较,差异有统计学意义[(30.1±4.4)vs.(23.4±3.8);t=5.462,P<0.001]。结论猴痘合并HIV感染/AIDS病例因CD4+淋巴细胞计数相对更低,易出现病变持久性、多样性和严重性等特点,需积极对症治疗及预防并发症。

Objective To analyze the clinical data of monkeypox(mpox)cases in Chengdu,to investigate the clinical characteristics of patients with mpox complicated with human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS),and provide reference for clinical diagnosis and treatment.Methods Mpox patients admitted to Public Health Clinical Center of Chengdu between June 29 and August 8,2023 were continuously included.Patients were divided into an observation group and a control group based on whether they were complicated with HIV/AIDS.The clinical characteristics of two groups of patients were observed and compared.Results A total of 56 patients were included,all of whom were male;Age range from 19 to 51 years old,with an average of(31.6±5.9)years old;There were 23 cases in the observation group and 33 cases in the control group.Except for age,perianal lesions with infection,number of rashes,diarrhea,CD4+lymphocyte count,CD4/CD8 ratio,syphilis,chest CT abnormalities,rash duration,and length of hospital stay(P<0.05),there was no statistically significant difference in epidemiological data,clinical features,auxiliary examinations,treatment,and intensive care unit admission between the two groups of patients(P>0.05).There was a statistically significant difference between the Ct values of throat swab nucleic acid and blister fluid nucleic acid in the total population[(30.1±4.4)vs.(23.4±3.8);t=5.462,P<0.001].Conclusions Mpox patients complicated with HIV/AIDS are prone to persistent,diverse,and severe lesions due to relatively lower CD4+lymphocyte counts.Therefore it is necessary to actively provide symptomatic treatment and prevent complications for patients.