人巨细胞病毒( human cytomegalovirus,HCMV)属β疱疹病毒亚科,人群对其普遍易感,成人HCMV感染率可达30%~100%[1].在机体免疫功能正常时,HCMV常呈隐性或潜伏感染,而在免疫功能低下或缺陷时(如移植受者、艾滋病患者等)常呈显性感...人巨细胞病毒( human cytomegalovirus,HCMV)属β疱疹病毒亚科,人群对其普遍易感,成人HCMV感染率可达30%~100%[1].在机体免疫功能正常时,HCMV常呈隐性或潜伏感染,而在免疫功能低下或缺陷时(如移植受者、艾滋病患者等)常呈显性感染.HCMV感染后不仅可通过直接的致细胞病变作用,引起HCMV症状和侵入性疾病(如HCMV肺炎、肝炎、胃肠炎、脑炎等),还可通过间接的宿主依赖的免疫病理作用,引起移植排斥、移植物损伤,诱发机会性感染等[2].HCMV感染可诱导激活其他人疱疹病毒( human herpesviruses,HHV)的活动性感染,如HHV-6、HHV-7、EB病毒(EBV)等[2],而有关其对多瘤病毒[多瘤BK病毒(BK virus,BKV)、多瘤JC病毒(JC virus,JCV)、乙型肝炎病毒(hepatitis B virus,HBV)、丙型肝炎病毒(Hepatitis C virus,HCV)]机会性感染的影响研究甚少.因此,本研究通过比较肾移植患者HCMV感染组和非感染组移植术后HCMV、BKV、JCV、HBV、HCV感染率的差别,来初步探究HCMV感染对上述病毒机会性感染的影响.展开更多
Highly active antiretroviral therapy (HAART) has dramatically decreased opportunistic infections (OIs) in human immunodef iciency virus (HIV)-infected patients. However,gastrointestinal disease continues to account fo...Highly active antiretroviral therapy (HAART) has dramatically decreased opportunistic infections (OIs) in human immunodef iciency virus (HIV)-infected patients. However,gastrointestinal disease continues to account for a high proportion of presenting symptoms in these patients. Gastrointestinal symptoms in treated patients who respond to therapy are more likely to the result of drug-induced complications than OI. Endoscopic evaluation of the gastrointestinal tract remains a cornerstone of diagnosis,especially in patients with advanced immunodeficiency,who are at risk for OI. The peripheral blood CD4 lymphocyte count helps to predict the risk of an OI,with the highest risk seen in HIV-infected patients with low CD4 count (< 200 cells/mm3). This review provides an update of the role of endoscopy in diagnosing OI in the upper gastrointestinal tract in HIV-infected patients in the era of HAART.展开更多
文摘人巨细胞病毒( human cytomegalovirus,HCMV)属β疱疹病毒亚科,人群对其普遍易感,成人HCMV感染率可达30%~100%[1].在机体免疫功能正常时,HCMV常呈隐性或潜伏感染,而在免疫功能低下或缺陷时(如移植受者、艾滋病患者等)常呈显性感染.HCMV感染后不仅可通过直接的致细胞病变作用,引起HCMV症状和侵入性疾病(如HCMV肺炎、肝炎、胃肠炎、脑炎等),还可通过间接的宿主依赖的免疫病理作用,引起移植排斥、移植物损伤,诱发机会性感染等[2].HCMV感染可诱导激活其他人疱疹病毒( human herpesviruses,HHV)的活动性感染,如HHV-6、HHV-7、EB病毒(EBV)等[2],而有关其对多瘤病毒[多瘤BK病毒(BK virus,BKV)、多瘤JC病毒(JC virus,JCV)、乙型肝炎病毒(hepatitis B virus,HBV)、丙型肝炎病毒(Hepatitis C virus,HCV)]机会性感染的影响研究甚少.因此,本研究通过比较肾移植患者HCMV感染组和非感染组移植术后HCMV、BKV、JCV、HBV、HCV感染率的差别,来初步探究HCMV感染对上述病毒机会性感染的影响.
文摘Highly active antiretroviral therapy (HAART) has dramatically decreased opportunistic infections (OIs) in human immunodef iciency virus (HIV)-infected patients. However,gastrointestinal disease continues to account for a high proportion of presenting symptoms in these patients. Gastrointestinal symptoms in treated patients who respond to therapy are more likely to the result of drug-induced complications than OI. Endoscopic evaluation of the gastrointestinal tract remains a cornerstone of diagnosis,especially in patients with advanced immunodeficiency,who are at risk for OI. The peripheral blood CD4 lymphocyte count helps to predict the risk of an OI,with the highest risk seen in HIV-infected patients with low CD4 count (< 200 cells/mm3). This review provides an update of the role of endoscopy in diagnosing OI in the upper gastrointestinal tract in HIV-infected patients in the era of HAART.