Investigation and Analysis on Pathogen Distribution of HIV/AIDS Patients with Opportunistic Infection

Objective: This study aims to understand the distribution of pathogenic bacteria in the region of HIV/AIDS patients with opportunistic infection. Methods: To count the number of the bacterial culture of HIV/AIDS patients in our hospital from October 2011 to December 2014, and observe the distribution of all kinds of pathogenic bacteria. Results: From the 4269 cases of HIV/AIDS patients’ bacteria, 5045 cases were cultured whose main flora distribution wasCandida albicans, 1759 cases. The second one was penicillium, 982 cases. The third one was mycobacteria, 557 cases. And then there are 213 cases ofCryptococcus neoformans, 212 cases of?Klebsiella pneumonia, 209 cases of?E. coli, 157 cases of coagulase-negative staphylococci, 112 cases of?Candida tropicalis, 90 cases of glabrata, 81 cases of?Staphylococcus aureus, 75 cases of?Pseudomonas aeruginosa, 60 cases of Salmonella, 48 cases of Acinetobacter and the distribution of the rest of cultured bacterial was less than 40 cases. Conclusion: There are many kinds of types of Pathogenic bacteria in HIV/AIDS patients with the opportunity to infectious. And the majorities are?Candida albicans,?Penicillium marneffei,?Penicillium,?Mycobacterium,?Cryptococcus neoformans?and so on. The infection sites are widely distributed;respiratory and circulatory are the main infected system. Improving the detection rate and reducing the contamination rate can truly reflect the distribution of pathogenic bacteria, and the distribution can guide the infection work in hospital. At the same time, it’s good to predict and prevent opportunistic infection. Thus, the patients can get immediate treatment.

A Retrospective Study of Culture-confirmed Mycobacterial Infection among Hospitalized HIV-infected Patients in Beijing, China

A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis（MTB） and non-tuberculous mycobacterial（NTM） infections in HIV-infected patients. A total of 627 patients＇ data were reviewed, and 102（16.3%） patients were diagnosed with culture-confirmed mycobacterial infection, including 84 with MTB, 16 with NTM, and 2 with both MTB and NTM. The most frequent clinical complication by mycobacterial infection was pulmonary infection（48/102, 47.1%）. The overall rates of multidrug-resistant TB（MDR-TB） and extensively drug-resistant TB（XDR-TB） were 11.9% and 3.4%, respectively. This study underlines the urgent need to intensify screening for mycobacteria coinfection with HIV and to prevent the spread of drug-resistant TB among HIV-infected patients.

Seroprevalence of IgG and IgM anti-Toxoplasma antibodies in HIV/AIDS patients,northern Iran

ObjectiveTo determine the seroprevalence of anti-Toxoplasma gondii (T. gondii) IgG and IgM antibodies in HIV/AIDS patients and uninfected subjects.MethodsThis cross sectional survey was carried out on 78 healthy and 62 HIV+/AIDS individuals in northern Iran between September 2007 and October 2008. Five mL of blood samples were collected from each person in case and control groups. Determination of CD4+ counts was performed by flow cytometry. The serum separated from blood samples was evaluated by conventional ELISA technique to determine the presence of antibodies to T. gondii.ResultsForty eight out of 62 (77.4%) HIV/AIDS serum samples were found positive for anti-T. gondii IgG antibody, compared with 59 among 78 (75.6%) HIV negative samples from the same area (P > 0.05). Six out of 62 (9.7%) HIV+/AIDS patients showed anti-T. gondii IgM antibody in their serum samples, compared with 7 among 78 (9%) HIV negative samples (P > 0.05). The mean of CD4+ counts in HIV+/AIDS was (430.8±182.3) cells/μL and in control group was (871.0±243.3)% cells/μL (P<0.01). CD4+ estimation in 5 (11.1%) of HIV+/AIDS patients was <200 cells/μL (P < 0.0001).ConclusionsSeroprevalence of latent toxoplasmosis in HIV patients is high, therefore the prevention of toxoplasmic encephalitis, administration of primary prophylaxis with co-trimoxazole to all HIV+/AIDS patients are necessary.

Correlation between Abdominal Ultrasonographic Findings and CD4 Cell Count in Adult Patients with HIV/AIDS in Jos, Nigeria

Acquired Immunodeficiency Syndrome (AIDS) is caused by Human Immunodeficiency Viruses (HIV) resulting in progressive destruction of cell mediated immunity. The abdominal manifestations of AIDS are related to the level of CD+4 cells count as well as viral load. Abdominal ultrasound examination is easy to perform, non-invasive, inexpensive, readily available and reproducible investigation which provides valuable information about abdominal findings in AIDS. The objective of the study was to evaluate abdominal ultrasound findings in adult HIV/AIDS patients in Jos, Plateau State, Nigeria and correlate these findings with the patients’ CD+4 counts. A cross-sectional study of abdominal ultrasound findings of adult patients with HIV/AIDS was conducted over a period of six months. The abdominal ultrasound findings and CD+4 counts were studied. Two hundred (40%) of the patients had normal abdominal ultrasound, while 60% (300) had various abnormalities. The common abnormalities included increased liver parenchymal echogenicity in 25.0%, hepatomegaly in 23.4%, splenomegaly in 6.6%, increased splenic echogenicity in 6.2% and thickened gallbladder wall in 12.6%, elevated renal parenchymal echogenicity in 6.4%, enlarged kidneys in 2.6%, lymphadenopathy in 6.0%, and ascites in 2.4%. Pelvic abscess was the least pathology in 0.2%. Most of the findings did not correlate with the patients’ CD+4?count except for lymphadenopathy and ascites. Although abdominal ultrasound examination is invaluable in the management of these patients, however, it has not shown to be useful in predicting the patients’ immune status.

An Assessment of the Level of Knowledge of HIV-Infected Patients about Highly Active Antireteroviral Therapy and Waiting Times and Their Influence on Antiretroviral Therapy Adherence at a Primary Healthcare Centre of South Africa

Objectives： The study assessed if the level of knowledge of HIV-infected about HAART and waiting-times in the PHC （primary healthcare） clinic have an influence on antiretroviral adherence. Methods： A descriptive-cross-sectional study was conducted in South Africa. Data collected uses a standardized-questionnaire and face-to-face-exit interviews. Pill-count technique was performed and a value of≥ 95% acceptable. Data were analysed using SPSS. Univariate-factors associated with poor-adherence to knowledge about HAART and waiting times were assessed using ANOVA and p ≤ 0.05 considered statistically significant. Key findings： Of 86 enrolled, 63（73.3%） were females and 23（26.7%） males, with mean-age （± SD） of 35.6（±9.6） years and on HAART for 35.5（± 31.8） months ranging from 1-137. Of these, 27（31.40%） and 25（29.07%） were on WHO stages 2 and 3 respectively. Adherence-rates computed from 32 patients, 23（71.9%） revealed poor adherence-rates. The level of knowledge about HAART in terms of names of tablets, correct-dose, frequency, adverse-effects had no influence on ARV-adherence （p _〉 0.05）. Of 23 non-compliant, 10 （40%） gave the reason of drugs-unavailability, 7（30%） adverse-effects, 5（20%） drugs＇ complexity, and 1（10%） too busy to take them. Waiting areas associated with poor ARV-adherence were reception （p = 0.028）, doctors （p = 0.027）, while nurse＇s station （p = 0.29） and pharmacy （p = 0.43） revealed acceptable ARV-adherence.

A comparative study of bacterial isolates from the urine samples of AIDS and non-AIDS patients in Benue,Nigeria

Objective:To determine the common bacterial causes of urinary tract infection and their antibiotic susceptibility pattern in AIDS patients versus non-AIDS patients.Methods:One thousand consecutive AIDS patients with signs and symptoms of AIDS and non-AIDS patients (served as control) each on admission were recruited into the study between January 2005 to January 2008,in Federal Medical Center,Makurdi.Urine samples were collected with sterile universal bottles and analysed with appropriate laboratory methods and antibiotic susceptibility test was carried out by disk diffusion technique in accordance with National Committee for Clinical Laboratory Standards(NCCLS,now CLSI) criteria.The results were analysed using SPSS 11.0 statistical software.Results:Urine samples of AIDS patients with urinary infection had a more spectrum of micro-organisms including Candida organisms,Pseudomonas aeruginosa and Staphylococcus aureus.Ceftriaxone,Ceftazidime or Ciprofloxacin had a remarkably high anti-bacterial activity across the two study groups.A general resistance was recorded in ampicillin.tetracycline and co-trimoxazole.There was no significant difference in antibiotic susceptibility patterns between AIDS and non- AIDS patients(P】0.05).Conclusions:A reduction in unnecessary use of antibiotics as well as infection control should be encouraged in our health facilities.

HIV/AIDS related mortality among adult medical patients in a tertiary health institution in South-South,Nigeria

Objective:To determine the causes of death among human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS) patients as a step to planning strategies to improve mortality from this condition.Methods:This study retrospectively analyzed the mortality pattern of adult HIV/AIDS patients in the University of Calabar Teaching Hospital from January 2005 to December 2007.The data were obtained from sexually transmitted infection/acquired immunodeficiency syndrome(STI/AIDS) clinic register,admissions and discharge/death registers as well as the patients’ case records and the hospitals monthly mortality reviews.Information obtained included age,sex,diagnosis and cause(s) of death.The causes of death considered were the direct causes of death,since the originating antecedent cause of death is the same in all the patients,in this case,HIV/AIDS.Data was analysed using Epi Info 2002.Results:The total number of mortalities during the study period was 350,100 were HIV positive representing 28.6%of all deaths.While advanced HIV/AIDS disease was the leading cause of death in our study representing 27.0%,tuberculosis was the single leading cause of deaths in HIV/AIDS patients constituting about 24.0%of deaths.This was followed by sepsis and septicaemia(13.0%), meningitis and encephalitis,and anaemia accounting for 11.0%,while respiratory diseases constituted 5.0%of the mortality burden.The highest number of deaths occurred in those aged between 21-50 years(82.0%).Conclusions:The study has shown that HIV/AIDS is a major cause of morbidity and mortality in our hospital.The causes of death reflect the varied spectrum of infection and other forms of organ involvement that affect HIV/AIDS patients.The present dismal situation of adult patients living with HIV/AIDS calls for enhanced strategies to decrease the mortality trend observed in Nigeria and sub-Saharan Africa.

High levels of Zinc-α-2-Glycoprotein among Omani AIDS patients on combined antiretroviral therapy

Objective:To investigate the levels of zinc-α-2-glycoprotein(ZAG) among Omani AIDS patients receiving combined antiretroviral therapy(cART).Methods:A total of 80 Omani AIDS patients(45 males and 33 females),average age of 36 vears.who were receiving cART at the Saltan Qaboos University Hospital(SQUH).Muscat,Oman,were tested for the levels of ZAG.In addition,SO healthy blood donors(46 males and 34 females),average age of 26 years,attending the SOUH Blood Bank,were tested in parallel as a control group.Measurement of the ZAG levels was performed using a competitive enzyme—linked immunosorbent assay and in accordance with the manufacturer's instructions.Results:The ZAG levels were found to he significantly higher among AIDS patients compared to the healthy individuals(P=0.033).A total of 56(70%) of the AIDS patients were found to have higher levels of ZAG and 16(20%) AIDS patients were found to have high ZAG levels,which are significantly(P>0.031) associated with weight loss.Conclusions:ZAG levels are high among Omani AIDS patients on cART and this necessitales the measurement of ZAG on routine basis,as it is associated with weight loss.

Analysis on Immune Tolerance and Resistance Mechanism of <i>Cryptococcus albidus</i>of AIDS Patients with Opportunistic Cryptococci Infection

Objective: To explore more about the immune tolerance and drug resistance of white Cryptococci albidus in AIDS patients with opportunistic Cryptococcus infection. Methods: To analyze drug resistance of the samples of white Cryptococcus albidus extracted from opportunistic infection AIDS patients in the certain infection area from October 2011 to December 2014. Results: After analyzing two samples of Cryptococcus albidus from 885 cases with opportunistic infection, we found that one of the samples do resist to ten common antibiotics. They were fluconazole, flu-cytosine, fluconazole, caspofungin, amphotericin B, MI miconazole, terbinafine, ketoconazole and itraconazole. The other one was sensitive to voriconazole, but resistant to the rest of the drug. Two strains of bacteria were inoculated into the animals in vivo and their DNA was extracted to carry out the genotyping analysis. The results showed that different degrees of resistance gene amplification bands were found in the 10 kinds of antibiotics. Conclusion: Although there were few opportunistic infection Cryptococcus albidus in AIDS patients, it was easy to show its resistance to drugs. Therefore, great attention should be paid to it for the medical workers.

Mindfulness-based therapies for patients living HIV/AIDS

Dear Editor,We read with great interest the systematic review and meta-analysis publishedby Yanget al.[1],assessing the impact of various mindfulness-based therapies(MBTs),including mindfulness stress reduction(MBSR)and mindfulness-based cognitive therapy(MBCT),on patients with HIV/AIDS[1].While we congratulate the authors for investigating this important topic,several issues pertaining to this study require further discussion.

Dermatophytes Species Isolated of HIV-Infected Patients Identified by ITS-RFLP and ITS Region Sequencing from Triangulo Mineiro, Minas Gerais State of Brazil

Dermatomycoses are a group of diseases worldwide distributed and affect skin, hair and nails. Several fungal species can be envolved and keratinophilic fungi belonging to the genera Trichophyton, Microsporum and Epidermophyton are very common. These infections are globally distributed and their incidence has progressively increased. Despite their high incidence, few studies have been carried out in HIV-infected patients, regarding frequency, clinical presentations, and species identification. This study aimed to evaluate some epidemiological and clinical aspects of dermatophytosis in HIV-infected patients and to attempt phenotypical and molecular characteristics of their agents. Of 398 patients included, 306 were HIV-infected. Clinical data and samples of skin, hair and nail lesions were simultaneously obtained. The dermatophytes yielded in culture were phenotypically identified and evaluated by ITS-RFLP and ITS (Internal Transcribed Space) sequencing. Dermatophytes frequency in HIV-infected patients with cutaneous lesions was 11.76% similar to the 15.22% observed in non-HIV individuals. Trichophyton rubrum was the most common isolated species in both groups. Throught ITS-RFLP, 29/32 (90.63%) of dermatophytes isolates were identified at the species level. From the 10 isolates randomly selected for ITS sequencing, seven confirmed the ITS-RFLP results while three Trichophyton sp. were not identified as dermatophytes. The identification of these species in HIV-infected patients is highly desirable in order to improve the knowledge of their frequency, geographical distribution and relation to clinical presentation.

Chronic Alcohol Consumption Affects Serum Enzymes Levels in the HIV-Infected Patients on Stavudine (d4T)/Lamivudine (3TC)/Nevirapine (NVP) Treatment Regimen

Chronic alcohol use is a common problem globally among the HIV-infected patients on ARV treatment regimens, leading to severe liver damage and increase in serum enzymes. The study determined effect of chronic alcohol intake on serum enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)) in HIV-infected patients on d4T/3TC/NVP treatment regimen in Uganda using the WHO alcohol use disorders’ identification test (AUDIT) tool and chronic alcohol use biomarkers (ALT, AST, GGT, AST/ALT ≥ 2.0 and mean corpuscular volume (MCV)). A case control study using repeated measure design with serial measurements model was used. Alcohol use biomarkers were used to standardize the gender differences in alcohol use. A total of 41 patients (21 alcohol group and 20 control group) were followed up for 9 months with blood sampling done at 3 month intervals. The serum enzymes’ levels were determined by using the Cobas Intergra 400 Plus analyzer system. The mean GGT levels were higher in chronic alcohol use group as compared to control group in both groups. The levels were above reference ranges during 6 month and three times higher during 9-month follow-up period for both chronic alcohol use self reporting WHO AUDIT tool and biomarkers’ groups. Generally, the mean AST, ALT and AST/ALT levels were slightly higher in alcohol use group as compared to control group and were slightly higher in both groups as compared to reference ranges during the 9 month follow-up period. Chronic alcohol consumption by HIV-infected patients on d4T/3TC/NVP drug regimen increased GGT and AST/ALT serum enzyme levels and hence was used as chronic alcohol use biomarkers.

Sustained heavy ethanol drinking affects CD4⁺cell counts in HIV-infected patients on stavudine (d4T), lamivudine (3TC) and nevirapine (NVP) treatment regimen during 9 months follow-up period

Sustained heavy ethanol drinking is a common problem globally and ethanol is one of the most abused drugs among individuals of different socio-economic status including the HIV-infected patients on antiretroviral drugs. Ethanol is reward drug and a CNS depressant especially at high doses. The study determined the effect of sustained heavy ethanol drinking by HIV-infected patients on d4T/3TC/NVP regimen on CD4+ cell counts in Uganda using WHO AUDIT tool and chronic alcohol-use biomarkers. A case control study using repeated measures design with serial measurements model was used. The patients on stavudine (d4T) 30 mg, lamivudine (3TC) 150 mg and nevirapine (NVP) 200 mg and chronic alcohol use were recruited. A total of 41 patients (20 in alcohol group and 21 in control group) were screened for chronic alcohol use by WHO AUDIT tool and chronic alcohol use biomarkers. They were followed up for 9 months with blood sampling done at 3 months intervals. CD4+ cell count was determined using Facscalibur Flow Cytometer system. Results were then sorted by alcohol-use biomarkers (GGT, MCV and AST/ ALT ratio). Data were analysed using SAS 2003 version 9.1 statistical package with repeated measures fixed model and the means were compared using student t-test. The mean CD4+ cell counts in all the groups were lower than the reference ranges at baseline and gradually increased at 3, 6 and 9 months of follow-up. The mean CD4+ cell counts were higher in the control group as compared to the chronic alcohol use group in both WHO AUDIT tool group and chronic alcohol-use biomarkers group though there was no significant difference (p > 0.05). Chronic alcohol use slightly lowers CD4+ cell count in HIV-infected patients on d4T/3TC/NVP treatment regimen.

Evidence of Renal Damage in HIV-Infected Patients with High CD4 Counts Following the Use of Traditional Medicine

Kidney dysfunction is one of the most serious complications resulting from the use of traditional medicine which is common in Africa accounting for about 35% of renal damage in HIV-infected patients. In this cross sectional study, 250 HIV-infected patients were groups as follows: ART GrpA (100), ART + traditional medicine use GrpB (100) and ART treatment naïve + traditional medicine GrpC (50). Tubular dysfunctions were defined when at least two or more of the following abnormalities were repeatedly present: Uricosuria ≥ 0.05 mg/dl, Phosphaturia ≥ 20.0 mg/dl, Glucosuria ≥ 0.1 mg/dl, Proteinuria = positive protein on dipstick urine. Renal dysfunctions were found to be significantly high (P = 0.001) in the group of patients treated with ART + traditional medicine. 27 (64.29%) patients followed by ART treatment naïve patients + traditional medicine;12 (28.57%) patients and only 4 (7.14%) patients developed renal toxicity in the ART treatment Grp. But strikingly CD4 counts were also significantly higher in Grp B (683 cell/ul) compared to group A (446 cell/ul) and C (206 cell/ul). Our results show that HIV-infected patients on ART combined with traditional medicine might develop renal abnormalities in the presence of high CD4 counts, in the course of incessant use of traditional medicine. Thus it is important that more research be conducted on its usage among the Black population with HIV infection.

Functional Health Literacy and Doctor-Patient Communication: Experiences of HIV/AIDS Patients in Homa Bay County, Kenya

Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to effective doctor-patient communication, which has an adverse effect on health outcomes. This study aimed at investigating the association of functional health literacy and doctor-patient communication among HIV/AIDS patients in Homa Bay County, Kenya. It was a cross-sectional hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay county. Data was collected using a self-administered structured questionnaire. Cronbach’s alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while Logistic regression logistic analysis was used to measure the association between functional health literacy and doctor-patient communication. 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. The respondents’ functional health literacy levels were inadequate at weighted means scores of 3.23 [SD 1.31]. The study further established that functional health literacy significantly influenced doctor-patient communication [Nagelkerke R square = 0.318]. There is, therefore, a need to document the determinants of functional health literacy to improve it and make doctor-patient interaction an enjoyable and meaningful experience.

Steps To ward HIV Cure Two more HIV-infected patients appear to be virus-free after bone-marrow transplants

THIS year＇s International AIDS Society Conference on HIV Pathogenesis, Treatment and Preven-／tion, held in Kuala Lumpur, Malaysia, made major headlines when Timothy Hendch, an American doctor, announced that two more cancer patients may have been cured of HIV after receiving bone-marrow transplants to treat lymphoma. Both patients had been taking retroviral medication, and continued to do so after the transplants as their viral levels sank until doctors were unable to find any traces of HIV in the patients＇ blood.

HIV/AIDS肺脾气虚证相关心脑血管疾病风险因素探析

目的通过检测血脂四项、血管内皮损伤因子、炎症相关因子,并结合前期的基因芯片结果,初步探讨人类免疫缺陷病毒(HIV)/艾滋病(AIDS)肺脾气虚证相关心脑血管疾病风险因素及机制,为中医药早期干预心脑血管疾病提供依据。方法2020年9月—2020年11月选取河南省某地区确诊的20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例HIV抗体阴性作为健康对照组。检测CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)计数,并计算CD_(4)^(+)/CD_(8)^(+)比值;检测血脂四项甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);检测氧化低密度脂蛋白(Ox-LDL)、载脂蛋白A-I(ApoAⅠ)、载脂蛋白A-Ⅱ(ApoAⅡ)、载脂蛋白B(ApoB)、锌-α2-糖蛋白1(AZGP1)、可溶性血栓调节蛋白(sTM)、血管性血友病因子(vWF)、脂联素、瘦素(LEP)、超敏C反应蛋白(Hs-CRP)、单核细胞趋化因子1(MCP-1)、肿瘤坏死因子α(TNF-α)。结果HIV/AIDS肺脾气虚证患者与健康对照组比较CD_(4)^(+)降低,CD_(4)^(+)/CD_(8)^(+)比值倒置,TC降低,sTM、AZGP1、Ox-LDL、Hs-CRP升高。结论HIV/AIDS肺脾气虚证患者存在炎性反应、血脂异常的表现,罹患心脑血管疾病风险增加。为中医药早期干预心脑血管疾病的发生提供新思路。

抗病毒治疗HIV/AIDS患者抑郁状况及其影响因素分析

【目的】了解接受抗病毒治疗HIV/AIDS患者抑郁状况及其影响因素。【方法】2022年7月-2022年9月,采用连续抽样法从南京市抗病毒治疗机构招募接受抗病毒治疗HIV/AIDS患者,进行匿名问卷调查,收集患者基本信息,采用患者健康问卷抑郁量表(PHQ-9)、简化的Berger艾滋病感知歧视量表(BHSS)及感知社会支持的多维度量表(MSPSS)调查抑郁状况、HIV耻辱得分以及社会支持水平等。采用多因素Logistic回归分析患者抑郁的影响因素。【结果】本研究共收集有效问卷1879份,抑郁检出率为50.1%,多因素logistic回归分析结果显示:相较于初中及以下文化程度的患者,研究生及以上文化程度抑郁的风险更低[OR=0.534,95%CI(0.341,0.835),P=0.006];相较于抗病毒治疗时长<1年,抗病毒治疗时长1~5年[OR=0.729,95%CI(0.536,0.991)]、>5~10年[OR=0.516,95%CI(0.379,0.702)]、>10年[OR=0.603,95%CI(0.375,0.969)]抑郁的风险更低;相较于中低社会支持水平,高社会支持水平是HIV/AIDS患者抑郁保护性因素[OR=0.430,95%CI(0.349,0.530),P<0.001];相较于未存在治疗药物副作用,存在药物副作用发生抑郁的风险更高[OR=2.260,95%CI(1.833,2.786),P<0.001];同时在HIV耻辱感量表得分越高,抑郁的可能性越高。【结论】南京市抗病毒治疗患者抑郁检出率较高,启动抗病毒治疗后应加强患者的药物副作用及心理状态监测,开展心理干预,缓解心理问题出现,提高患者的生命质量。