【摘要】 目的 观察人类免疫缺陷病毒（HIV）感染后对人体各个系统的影响，为其诊断和治疗提供经验。 方法 回顾性分析2005年1月—2010年6月于华西医院确诊为HIV感染13例患者的临床表现和相关实验室指标。 结果 13例HIV感染患者均合并其他感染，以结核病最为常见；除有T淋巴细胞异常外，多数患者可合并出现血液学异常，包括贫血、白细胞和血小板降低；生化异常，包括球蛋白升高、白蛋白降低；HIV感染患者可合并出现风湿病症状和免疫学异常。 结论 HIV感染患者临床表现复杂多样，可合并出现多种感染和风湿病症状，血液学及免疫学异常也比较常见。【Abstract】 Objective To observe the impact of human immunodeficiency virus (HIV) on each system of human body after its infection, in order to provide experiences for diagnosis and treatment of this disease. Methods The clinical manifestations and related laboratory results of 13 inpatients treated in West China Hospital of Sichuan University from January 2005 to June 2010 were reviewed retrospectively. Results The incidence of infection in these patients was 100% with tuberculosis as the most common infection. Apart from the abnormality of T lymphocytes, most patients had a change of hematology and biochemistry, including anemia, depression of leucocytes and platelets, hyperglobulinemia and hypoproteinemia; HIV-infected patients may also presented with rheumatic manifestations or abnormality in the immune system. Conclusion The clinical manifestations of patients with AIDS are complicated. Many kinds of infections and rheumatic manifestations may merge and the change in hematology and immunology is common.
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.
Objective To evaluate the relation of human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) loads in cerebrospinal fluid with central neurological diseases. Methods The inpatients with HIV-1 infection diagnosed by Public Health Clinical Center of Chengdu between January 1st, 2015 and March 1st, 2018 were retrospectively included. The included patients were divided into central neurological disease group and non-central neurological disease group, and high viral load group and low viral load group. The demographic data, CD4+ T lymphocyte count, routine detection of cerebrospinal fluid, HIV RNA load in cerebrospinal fluid and plasma of patients with and without central neurological diseases were observed and compared.Multiple logistic regression analysis was used to identify risk factors for central neurological diseases. Results A total of 367 patients were included. In the central neurological disease group, 210 cases (57.22%) were complicated with central neurological diseases, and cryptococcus infection was the most. Compared with the non-central neurological disease group, the increase rate of cerebrospinal fluid cell counts, cerebrospinal fluid cell counts, cerebrospinal fluid HIV RNA positivity and cerebrospinal fluid HIV RNA load were higher in the central neurological disease group (P<0.05). Logistic regression analysis showed that HIV RNA load in cerebrospinal fluid≥100 000 copies/mL and CD4+ T lymphocyte count<200 cells/mm3 were risk factors for central neurological diseases. Conclusion Cerebrospinal fluid HIV RNA load≥100 000 copies/mL is an independent risk factor for HIV/AIDS patients with central neurological diseases and clinical treatment should take this factor into consideration to reasonably optimize the selection of antiretroviral therapy.
With the widespread adoption of antiretroviral therapy, vast improvements in the life expectancy of individuals infected with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) were seen, and the liver disease of this population has become a leading cause of mortality. Although liver transplantation is as an effective treatment for end-stage liver disease, it remains in its nascent stage for the patients with HIV/AIDS in China, lacking standardized protocols and substantial clinical experience. Therefore, a “Multicenter expert consensus on perioperative management of liver transplantation in patients with human immunodeficiency virus infection” was formulated. This expert consensus aims to standardize and optimize the diagnosis and treatment process for liver transplantation in HIV-infected patients, providing systematic guidance for this procedure in China and fostering multidisciplinary collaboration and development in the field. This expert consensus clearly delineates the indications and contraindications for liver transplantation in HIV-infected patients, emphasizing comprehensive preoperative evaluations of both donors and recipients. These evaluations include infection control measures, immune function monitoring, and management of comorbidities. In terms of surgical procedures, strategies to prevent occupational exposure and intraoperative guidelines are outlined. Postoperatively, the focus is on antiviral therapy, individualized immunosuppression management, and vigilant monitoring of complications to ensure patient recovery and long-term survival. The long-term follow-up management prioritizes regular assessments of liver function, immune status, and HIV-related indicators to adjust treatment plans and enhance patient survival rates and quality of life. With the continuous enrichment of clinical experience and the progress of clinical research, this consensus will be continuously updated.
ObjectiveTo investigate the ultrasonic changes of liver during various immune periods with different number of CD4+ T lymphocytes in HIV/AIDS patients with chronic viral hepatitis. MethodsThe clinical data of 100 patients with chronic viral hepatitis diagnosed between January 2010 and December 2012 were selected. Among them, 50 simple chronic viral hepatitis patients were designated as the control group, and the other 50 HIV/AIDS patients with chronic viral hepatitis were regarded as the experimental group. Ultrasonographic observation was applied on patients of the experimental group according to different immune period based on the number of CD4+ T lymphocytes. Indexes observed included liver size, the edge of liver, capsule of liver and hepatic parenchymal echo. The cross-check analysis was employed between observed results and clinical laboratory results. ResultsAbnormal changes of the experimental group were shown on the ultrasound observation of liver in different CD4+ T lymphocyte count immune periods, including enlargement of the liver, slightly blunt liver margin, slightly thick capsule, dense and uniform, slightly rough and not so uniform, or rough and not uniform hepatic parenchymal echo. There was no significant difference in ultrasonic changes of liver between the two groups when the CD4+ T cell number was over 300/mm3. However, the difference was significant when the CD4+ T cell number was below 100/mm3. ConclusionLiver abnormalities become more obvious as CD4+ T cell count decreases in HIV/AIDS patients with chronic viral hepatitis. Comprehensive considerations of various liver ultrasound indicators are helpful in clinical evaluation of HIV/AIDS patients with chronic viral hepatitis.
目的:进一步认识获得性免疫缺陷综合征（AIDS）并发机会感染的临床特点，提高临床诊断水平，减少误诊。方法:回顾性分析我院85例住院的AIDS患者的临床资料。包括临床表现、常见的机会感染、实验室检查异常情况及机会感染的确诊时间等情况。结果:本组资料中发生机会感染患者主要为青壮年男性，发病后误诊率为70%，大多经两家医院就诊后确诊。60%以上患者首诊于非感染科。临床表现主要有发热、咳嗽、腹泻、消瘦、皮疹、贫血等症状和体征。肺部感染35例（14%），肺结核12例（14%），乙型肝炎9例（10%），丙型肝炎10例（11%），梅毒 7例（8%），耶氏肺孢子菌肺炎（PCP）15例（17%），败血症1例 （1%）。结论:HIV机会感染呈多器官受累，临床表现复杂，不具特异性。临床应提高认识，减少误诊。
Objective To evaluate the performance of i3000 direct chemiluminescence detection of human immunodeficiency virus (HIV) antigen and antibody (Ag/Ab) screening assay (Maccura), compared with E170 electrochemiluminescence method (Roche, Elecsys® HIV Combi PT assay) and IS1200 indirect chemiluminescence method (Maccura). Methods Ten HIV seroconversion panels and 11 p24 antigen positive samples from West China Hospital of Sichuan University from April to December 2017 were used to evaluate the sensitivity of those three assays. A total of 351 samples were collected for consistency evaluation, including 350 HIV Ag/Ab test samples (200 HIV-1 positive plasma samples and 150 HIV 1+2 negative plasma samples) from West China Hospital of Sichuan University from April to December 2017, and one commercial HIV-2 sera. A total of 98 interfere samples for HIV testing were collected from West China Hospital of Sichuan University from April to December 2017. Results In the sensitivity evaluation, there were 63 samples from the 10 seroconversion panels, in which Roche E170 detected 25 samples, Maccura i3000 detected 23 samples, and Maccura IS1200 detected 22 samples; Maccura i3000 and Roche E170 assays detected all the p24 antigen positive samples (11, 100%), while Maccura IS1200 only detected 10 samples. In the consistency evaluation, Maccura i3000 had nice consistency with both Roche E170 and Maccura IS1200 (kappa>0.9, P<0.001). In the interference evaluation, there were two false positives in Maccura i3000 detection, one case of rheumatoid arthritis and one case of syphilis. Conclusion In addition to high throughput and good consistency, Maccura i3000 direct chemiluminescence reagent has high sensitivity and a short window period, which can meet clinical needs.
【摘要】 目的 研究人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合症(AIDS)患者CD4+T淋巴细胞数变化(ΔCD4+T)和外周血淋巴细胞总数变化(ΔTLC)的相关性。探讨用ΔTLC预测ΔCD4+T在监测HIV/AIDS患者疾病进展以及高效抗逆转录病毒治疗(HAART)疗效的价值。 方法 回顾性分析2005〖CD3/5〗2008年确诊的91例HIV/AIDS患者的临床资料。 结果 ΔTLC与ΔCD4+T呈直线正相关(r=0809,Plt;001),好于TLC与CD4+T的相关性(r=0712,Plt;001)。分别用ΔTLC 170、330、630、910个/μL细胞预测ΔCD4+T 50、100、200、300个/μL细胞时具有较好的预测价值,各项评价指标符合率基本达到90%以上,显著高于相同时间下用TLC预测CD4+T计数的价值。 结论 应用ΔTLC预测ΔCD4+T,可比TLC更加直观、准确的反映HIV感染者疾病进展和评价AIDS患者HAART的疗效。【Abstract 】Objective To assess the utility of total lymphocyte count (TLC) changes (ΔTLC) in place of TLC to predict the development of HIV/AIDS. To investigate the monitoring value of ΔCD4+T on progress of HIV/AIDS and HAART which predicted by ΔTLC. Methods Clinical data of 91 patiens with HIV/AIDS diagnosed from 2005 to 2009 were retrospectively analyzed. Results A linear correlation was found between the value of ΔTLC and the value of CD4+T changes(ΔCD4+T)(r=0809,Plt;001),which was better than the correlation between TLC and CD4+T (r=0712,Plt;001).Using ΔTLC as 170,330,630,910 cells/μL,respectively for forecasting ΔCD4+T as 50,100,200,300 cells/μL,respectively,had a better predictive value with the area under ROC curve near to 09,significantly higher than using TLC for predicting CD4+T counts. Conclusion ΔTLC is more accurate than TLC to reflect the development of HIV/AIDS.