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。

2004—2022年河南省平顶山市HIV/AIDS患者抗病毒治疗效果分析

目的通过分析平顶山市2004—2022年人类免疫缺陷病毒(HIV)/艾滋病(AIDS)患者抗病毒治疗情况,评估抗病毒治疗效果,为本区域的艾滋病防治工作提供科学依据。方法使用“中国疾病预防控制信息系统”,下载2004—2022年现地址在平顶山市,抗病毒治疗满6个月及以上的HIV/AIDS病例数据资料,检测CD4^(+)T淋巴细胞和病毒载量,分别作为抗病毒治疗效果的免疫学和病毒学评价指标。对数据统计分析采用SPSS 22.0。结果共纳入2186例患者,治疗前基线CD4^(+)T细胞计数均值为(286.32±189.81)个/μl,抗病毒治疗后最近一次随访检测CD4^(+)T细胞计数均值为(446.45±221.96)个/μl,抗病毒治疗前后CD4^(+)T细胞结果分布差异有统计学意义(χ^(2)=641.53,P<0.001)。患者最近一次随访检测VL<20 copies/ml有1875例(85.77%),构成比呈逐渐上升趋势(χ^(2)=16.970,P<0.001)。Spearman检验抗病毒治疗后CD4^(+)T细胞与VL结果呈负相关(r=-0.143,P<0.001)。结论平顶山市在治的抗病毒治疗HIV/AIDS患者,免疫重建和病毒抑制情况较好,应继续扩大检测、早发现、早治疗,加强患者服药依从性教育,坚持长期规范治疗,进一步提高抗病毒治疗质量。

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.

联合抗反转录病毒治疗后HIV/AIDS患者的消化道症状及影响因素

目的探讨HIV/AIDS患者在联合抗反转录病毒治疗后不同免疫应答状态下消化道症状的差别并分析其影响因素,为HIV/AIDS患者抗病毒治疗后的免疫重建和病情控制提供参考依据。方法利用查阅病历资料、发放问卷调查等方式对解放军总医院第五医学中心2021年1月至2024年1月病房收治与门诊接诊的229例HIV/AIDS患者的一般及临床资料进行回顾性分析。所有患者均经过2年及以上的联合抗反转录病毒治疗,按照患者免疫应答状态的不同进行分组,比较其出现消化道症状的差别并分析影响因素。结果229例患者中存在消化道症状者68例,占比29.69%,其中免疫应答患者、不完全免疫应答患者和免疫无应答患者出现消化道症状的比例分别为31.19%、20.51%和32.10%,3组中最常见的症状均为腹痛腹泻,占比分别为19.27%、7.69%和17.28%,Logistic多因素分析发现性别为男性、感染途径为同性性接触传播、CD4/CD8比值倒置是患者出现消化道症状的促进因素。结论HIV/AIDS患者经联合抗反转录病毒治疗后消化道症状仍然常见,其中腹痛腹泻出现的比例最高,该类症状的存在可能与患者性别、感染途径、CD4/CD8比值有关。因此,HIV/AIDS患者抗病毒治疗后仍应继续关注患者的消化道症状表现并及时处理,定期监测其CD4^(+)T细胞计数、CD4/CD8比值水平,对于控制消化道病变及其他HIV/AIDS相关并发症、延缓患者病情发展具有重要的临床意义。

我国近10年HIV感染/AIDS病人抑郁研究的可视化分析

目的:梳理人类免疫缺陷病毒(HIV)感染/艾滋病(AIDS)病人抑郁领域的研究现状、热点及趋势,为后续研究提供思路方向。方法:检索中国知网(CNKI)、万方数据库、维普数据库(VIP)2013年1月1日—2023年4月26日收录的HIV感染/AIDS病人抑郁相关研究文献。采用CiteSpace 6.2.R2、NoteExpress对发文量、核心作者、来源机构、来源期刊、高频关键词、关键词聚类及突现词进行数据分析。结果:最终纳入文献551篇。该领域发文量总体呈上升趋势,发文期刊主要有《中国艾滋病性病》《中华疾病控制杂志》《护理研究》等。涉及377位作者,形成以陈曦、王敏、杨淑娟等为代表的科研团队,发文机构以医学院校和医院为主。高频关键词有艾滋病(254次)、抑郁(207次)、焦虑(146次)、心理护理(47次)、影响因素(43次)等,共形成焦虑、抑郁症、心理护理、肺结核、抑郁症状等8个聚类标签;突现词结果显示,抑郁症、中医药、中老年、满意度、睡眠障碍为2019年之后的研究前沿。结论:近10年该领域的研究热度不断提升,研究主要关注HIV感染/AIDS病人抑郁表现、干预及治疗手段三大方面,中医药有望成为应对HIV感染/AIDS病人抑郁的方式。然而,各研究团队之间缺少密切的学术交流,未见明显的跨团队合作网络。各研究团队应在今后的研究中建立紧密的跨学科联系,把握研究前沿,力争实现“零艾滋”的目标。

影响HIV感染者/AIDS患者心理健康状况的相关因素及护理干预措施研究

目的:分析影响人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者心理健康状况的相关因素,探讨用于HIV感染者/AIDS患者的护理干预方案。方法:依据入院时间将本院收治的120例HIV感染者/AIDS患者分成对照组和观察组各60例,对照组采用常规护理干预,观察组应用心理护理干预;收集患者基线资料并进行心理健康状况影响因素分析;运用抑郁自评量表(SDS)、焦虑自评量表(SAS)、简化Berger艾滋病耻辱量表(BHSS)和社会支持评定量表(SSS)对患者进行心理健康状况评估并比较两组护理干预效果。结果:年龄大于50岁、家庭年收入小于5万元、已婚和病程在10年以上是影响HIV感染者/AIDS患者的高危因素(P<0.05);护理干预后,观察组患者的SAS、SDS、BHSS分数更低,SSS更高(P<0.05)。结论:影响HIV感染者/AIDS患者心理健康的因素较为多样化,及时干预避免抑郁情绪有利于提高患者的生活质量,促使其恢复正常生活。

淄博市2000—2021年HIV/AIDS患者生存时间及影响因素分析

目的探究淄博市2000年1月—2021年12月艾滋病病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immune deficiency syndrome,AIDS)患者生存时间及影响因素。方法采用回顾性分析对2000年1月—2021年12月淄博市HIV/AIDS患者的临床资料进行研究统计其生存情况,绘制生存曲线,并分析患者生存时间的影响因素。结果1203例HIV/AIDS患者纳入队列,全死因死亡147例(12.22%),平均生存时间(168.48±5.82)个月,第1、3、5、10年累计生存率分别为90.42%、88.01%、85.94%、80.58%。单因素分析结果显示,患者不同民族、婚姻状况、确定感染时的年龄、职业、文化程度、感染途径、样本来源、首次检测CD4^(+)T淋巴细胞计数、是否接受抗病毒治疗与生存时间有关(P<0.05);多因素分析结果显示,婚姻状况离异或丧偶[β=0.515,HR=1.673,95%CI 1.129~2.479]、未接受抗病毒治疗[β=2.088,HR=8.067,95%CI 4.176~15.582]是影响淄博市HIV/AIDS患者生存时间的独立危险因素(P<0.05),文化程度大专及以上[(β=-1.168,HR=0.311,95%CI 0.146~0.663)、文化程度不详(β=-2.417,HR=0.089,95%CI 0.012~0.686)、样本来源检测咨询(β=-0.946,HR=0.388,95%CI 0.242~0.624)、首次检测CD4^(+)T]淋巴细胞计数351~<500个/μL(β=-0.856,HR=0.425,95%CI 0.211~0.854)、首次检测CD4^(+)T淋巴细胞计数≥500个/μL(β=-0.948,HR=0.387,95%CI 0.173~0.865)是影响淄博市HIV/AIDS患者生存时间的保护性因素(P<0.05)。结论淄博市HIV/AIDS患者的生存率较高,HIV/AIDS患者生存时间受多种因素影响,应加强早发现和早治疗工作,延长HIV感染/AIDS患者生存时间,体现了《HIV/AIDS诊断标准和处理原则》的执行标准。

来宾市HIV/AIDS患者配偶HIV感染状况及其影响因素分析

目的 了解来宾市HIV/AIDS患者配偶HIV感染现状及其影响因素,为今后当地艾滋病随访管理中促进与完善配偶检测相关工作、控制配偶间HIV传播提供依据。方法 选取2019-2020年报告的、现住址为来宾市、能随访到的、已婚有配偶的HIV/AIDS患者配偶纳入监测对象,调查其HIV抗体检测情况,应用单因素和多因素logistic回归模型分析HIV/AIDS患者配偶感染HIV的影响因素。结果 共调查411例HIV/AIDS患者配偶,HIV抗体阳性率为52.31%。性别以女性为主(63.99%),年龄以60岁及以上为主(46.47%),教育程度以小学为主(46.96%),民族以壮族为主(74.70%)。单因素分析显示,HIV/AIDS患者配偶感染HIV与性别、年龄、知道获得免费咨询与检测情况、知道需要定期检测HIV以及知道早治疗能提高生活质量等因素均存在统计学关联(P值均<0.05)。多因素logistic回归分析显示,HIV/AIDS患者配偶感染HIV的风险:女性是男性的0.362倍(95%CI:0.226-0.580),20~39岁、40~59岁分别是60岁及以上的0.293倍(95%CI:0.122-0.701)、0.275倍(95%CI:0.169-0.450),不知道获得免费咨询与检测者是知道者的11.372倍(95%CI:3.484-37.118),不知道早治疗能提高生活质量者是知道者的28.380倍(95%CI:8.098-99.455)。结论 来宾市配偶间传播是造成艾滋病经异性传播的重要途径之一,应针对重点人群扩大筛查,对配偶进行咨询检测,早发现、早干预、早治疗,减少配偶间HIV的传播。

Interferon γ in patients with HIV/AIDS and suspicion or latent tuberculosis infection

Objective:To assess the usefulness of IGRA test(QuantiFERON? -Cell mediated immune) compared with the tuberculin skin test.Methods:A cross-sectional study was carried out in Mexico,25 infected patients with HIV-AIDS and the suspicion or with latent tuberculous infection （LTBI） who were】18 years of age and without treatment for tuberculosis（TB）,were enrolled in the study.Results:Median cluster of differentiation（CD4） count was 364 cells/μL and median HIV viral load was 50 copies/mL.Overall,20 patients（80%） had at least one positive diagnostic test for LTBI:four（16%） had a positive tuberculin skin test and 19（76%）,a positive QuantiFERON ? -tuberculosis.Conclusions:No agreement is found between the two diagnostic tests:k = -0.004,95%confidence interval（-0.2219,0.2210）.Additional longitudinal studies among HIV-infected populations with high prevalence of TB are needed to further assess the usefulness of IGRAs in this patient population.

Characterization of Candida Species Isolated from Cases of Lower Respiratory Tract Infection among HIV/AIDS Patients in Calabar, Nigeria

This study was designed to identify and characterize the Candida species isolated from lower respiratory tract infections among HIV positive patients and to determine the prevalence rates of Candida infections among these subjects. Two early morning expectorate sputum samples were collected from 272 HIV positive subjects visiting the ART clinics and DOTS centre with cases of lower respiratory tract infection, over a period of 14 months from May 2009 to July 2010 in Calabar. Subjects were recruited for this study upon approval by the Ethical Research Committee of the University of Calabar Teaching Hospital and obtaining written informed consent from the patients. Samples were processed by standard methods for isolation of Candida. Speciation was done by a germ tube test, chlamydospore production on corn meal agar and sugar fermentation and assimilation tests using the Microexpress Candida identification kit (Tulip, India). Out of the 544 sputum samples collected from 272 subjects, Candida species were isolated from 40 (14.7%) and identified after confirming the growth in the second sample. The majority of Candida species among the Candida isolates were Candida albicans (80%) followed by Candida tropicalis 5 (12.5%), Candida dubliniensis 2 (5.0%) and Candida guilliermondii 1 (2.5%). The isolation rate of Candida species from sputum samples was found to be highest among subjects aged 25 - 34 years, followed by those aged 15 - 24 years. Twenty (7.3%) HIV seropositive subjects had bacterial infections, while 4 (1.5%) subjects had mixed fungal and bacterial infections. This study is the first of its kind to be carried out in Calabar and the South-South geopolitical region of Nigeria, and has shown that pulmonary candidiasis is a health problem among HIV positive patients in Calabar.

Cross-Sectional Study of Tuberculosis and HIV/AIDS Co-Infections among Patients Attending Directly Observed Treatment Centers in Bayelsa State, Nigeria

Introduction: Mycobacterium tuberculosis (TB) infects about one quarter of the global population and is transmitted via aerosols by coughing, sneezing, etc. Some socio-behavioral factors may predispose an individual to the disease. Methodology: The study used a cross-sectional design with random stratified sampling technique. Sputum samples from suspected TB patients totaling 600 were obtained from patients attending directly observed treatment (DOTs) centers from different local government areas in Bayelsa. The sputum samples were examined for tuberculosis using the Ziehl-Neelsen staining technique and Gene Xpert molecular method while HIV/AIDS tests were carried out with EDTA blood using the Alere HIV12 test kit and others. Results: The Prevalence of TB by Gene Xpert was 294 (49.0%) and by AFB 217 (36.1%), while TB/HIV co-infection was 94 (32.0%), RRMTB was 34 (11.9%) and HIV 249 (41.5%). Prevalence by age group showed the 20 - 39 years had the highest prevalence of TB 98 (47.0%), TB/HIV 35 (47.0%), RRMTB 17 (48.0%) and HIV 90 (57.0%). By gender the male had slightly higher prevalence of TB 109 (52.0%), TB/HIV 51 (54.0%), RRMTB 20 (56.0%) and HIV 126 (51.0%) than the female. Prevalence among smokers and alcoholics and subjects who engaged in both habits had high prevalence TB 109 (37.0%), TB/HIV 14 (40.0%), RRMTB 14 (40.0%) and HIV 72 (29.0%). For educational status those with tertiary and secondary education had similar high prevalence and for occupation, the self-employed and civil servants had similar elevated prevalence. The prevalence by local government area showed that Yenegoa had the highest with TB 235 (80.0%), TB/HIV 72 (76.6%), RRMTB 24 (68.5%) and HIV 202 (81.2%). Conclusion: An increase in the development of resistance by M. tuberculosis also contributes to the persistence of the disease as well as some socio-economic factors.

Exploring the Impact of Factors Affecting the Lifespan of HIVs/AIDS Patient’s Survival: An Investigation Using Advanced Statistical Techniques

This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.

Exploring the Impact of Factors Affecting the Lifespan of HIVs/AIDS Patient’s Survival: An Investigation Using Advanced Statistical Techniques

This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.

云南省大理州50岁及以上HIV/AIDS患者生存状况分析

背景云南省大理州1997年首次报告50岁及以上人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immunodeficiency syndrome,AIDS)患者(简称HIV/AIDS患者),2010年以后50岁及以上HIV/AIDS患者报告数呈现明显上升趋势。2017年公布的《中国遏制与防治艾滋病“十三五”行动计划》中,已正式将老年人作为艾滋病防治的重点人群之一。目的分析大理州50岁及以上HIV/AIDS患者的生存状况。方法对1997-2018年报告的50岁及以上HIV/AIDS患者,运用寿命表法计算生存率,运用Cox回归分析生存的影响因素。结果大理州2019例50岁及以上HIV/AIDS患者的中位生存时间为8.33年(95%CI:7.75~9.33)。寿命表法分析结果显示确诊后1年、5年、10年的生存率分别为74.76%、56.26%、40.29%。Cox回归分析结果显示50岁及以上HIV/AIDS患者男性死亡风险是女性的1.74倍(95%CI:1.43~2.12);未抗病毒治疗患者的死亡风险是抗病毒治疗患者的9.32倍(95%CI:7.86~11.05);2010年以后报告患者死亡风险是2010年及以前报告患者的0.62倍(95%CI:0.52~0.74)。结论应加强对50岁及以上中老年人群的艾滋病防治工作,早检测、早发现、早治疗是此类人群艾滋病防治的重点措施。

427例HIV/AIDS患者合并HCV感染的临床分析

目的探讨广西住院HIV/AIDS患者合并HCV感染现状及临床特点。方法回顾性分析2018—2022年在我院首次住院治疗的13142例HIV/AIDS患者合并HCV的感染率。收集HIV/AIDS合并HCV感染患者(HIV/HCV组)的一般及临床资料,探讨感染途径和直接抗病毒药物(direct-acting antivirals,DAAs)治疗情况;纳入354例同期收治单纯HCV感染者作为对照;分析2组患者重症肝病的发生率和重症肝病致死率。结果13142例HIV/AIDS患者中,427例合并HCV感染,感染率达3.25%。HIV/HCV组感染途径85.71%为异性性传播。与单纯HCV组相比,HIV/HCV组肝衰竭的发生率和重症肝病致死率更高(P均<0.05)。对51例HIV/AIDS合并HCV感染患者进行HCV基因分型:la型占19.61%、lb型占13.73%、2a型占3.92%、3a型占11.76%、3b型占17.65%、6a型占29.41%,6d型占1.96%、6e型占1.96%。427例患者中入院前接受DAAs治疗者仅占1.41%(6/427)。对106例未行DAAs治疗患者分析显示,农民占53.77%,城镇无固定职业者占34.91%;首次在我院检查发现抗-HCV阳性者占64.15%(68/106),院外已确证丙型肝炎多年的37例患者中,不愿意治疗者占83.78%(31/37)。结论广西HIV/AIDS患者合并HCV感染比例高,性传播是合并HCV感染的主要途径,HCV基因型以1、3、6型为主,HIV合并HCV感染易导致肝病重症化,可增加病死率,入院前接受DAAs治疗率很低。因此,对合并HCV感染的HIV/AIDS患者,应加强宣教,提高其依从性,应尽早进行DDAs治疗,改善其预后。

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.

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.