浅表淋巴结肿大的151例艾滋病患者淋巴结病理学分析

目的 探讨浅表淋巴结肿大的HIV/AIDS患者的淋巴结病理类型及其特点.方法 取浅表淋巴结肿大的151例HIV/AIDS患者的淋巴结组织进行病理学检查,通过HE、抗酸、过碘酸雪夫和淀粉酶消化后过碘酸雪夫染色,光学显微镜下观察,描述和分析其病理结果及其与CD4+T淋巴细胞计数的关系.数据行卡方检验.结果 在151例HIV/AIDS患者的淋巴结病理结果中,表现为良性病变的有145例,占96.0%,表现为恶性肿瘤的有6例,占4.0%,其中结核病72例,淋巴结反应性增生34例,淋巴真菌感染23例(其中青霉病19例),AIDS相关淋巴结病14例,非霍奇金淋巴瘤5例,良性纤维组织细胞病1例,结核伴发真菌感染1例,间叶性恶性肿瘤1例.在所有患者中,CD4+T淋巴细胞计数<100×106/L的有83例,占55.0%.青霉病随着CD4+T淋巴细胞计数的减少,发病率明显升高(x2=7.757,P=0.021).结论 HIV/AIDS患者浅表淋巴结肿大的原因大多数为感染性疾病,主要为结核病及真菌感染,且多数发生在CD4+T淋巴细胞计数低下的患者,最常见的恶性肿瘤为非霍奇金淋巴瘤.

Abstract：

Objective To investigate the pathological types and features of lymph nodes in human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)patients with superficial lymphadenectasis.Methods The tissues of lymph nodes were obtained from 151 HIV/AIDS patients with superficial lymphadenectasis for pathological examination.The pathological results were observed by light microscope after Hematoxylin-Eosin(HE),acid-fast,periodic acid-Schiff (PAS),and digested-PAS(D-PAS)staining.The pathological results of lymph nodes were described and the correlation between pathological changes and CD4+T lymphocyte count was analyzed.Chisquare test was used for the statistic analysis.Results The benign lesions were found in 145 patients (96.0%),while the malignant tumors were found in 6 patients(4.0%).The pathological findings in the 151 HIV/AIDS patients included tuberculosis(72 patients),lymph node reactive hyperplasia(34patients),lymphatic fungal infections(23 patients,including penicillium diseases in 19 cases),AIDSrelated lymphadenectasis(14 cases),non-Hodgkin lymphoma(5 cases),benign fibrous histiocytoma (1 case).In addition,there were 83 patients(55.0%)with CD4+T lymphocyte count lower than 100×106/L.The frequency of penicillium diseases was higher in patients with lower CD4+T lymphocyte count(x2=7.757,P=0.021).Conclusions The major reasons for superficial lymphadenectasis in HIV/AIDS patients are infectious diseases,such as tuberculosis and fungal infections,which are common in patients with lower CD4+T lymphocyte counts.Non-Hodgkin lymphoma is the most common malignant tumor in this patient population.     

Clinical characteristics and T-lymphocyte subsets in 48 acquired immune deficiency syndrome patients with cytomegalovirus infections

<正>Objective To investigate the clinical features and T lymphocytes subsets in patients with acquired immune deficiency syndrome (AIDS) and cytomegalovirus(CMV) infection. Methods A total of 48 hospitalized patients with human immunodeficiency virus (HIV)-1/AIDS and CMV infections were recruited at Peking Union     

Clinicopathological and prognostic analysis of IgA nephropathy patients with anemia

正Objective To analyze the clinicopathological features of IgA nephropathy (IgAN) patients with anemia and the influencing factors of prognosis.Methods The clinical and pathological data of patients diagnosed with primary IgAN at the First Affiliated Hospital of Fujian Medical University from January 1,2006 to December 31,2016were retrospectively analyzed.The patients were divided     

Toxoplasma gondii and human immunodeficiency virus co-infection in western Iran: A cross sectional study

Objective: To determine Toxoplasma gondii(T. gondii) as a cause of morbidity and mortality in human immunodeficiency virus(HIV) infected patients by ELISA method and to investigate toxoplasmosis-associated risk factors. Methods: This cross sectional study was conducted with 385 patients with HIV/AIDS referred to the behavior disease consultation center in Kermanshah, Iran between May 2012 and June 2013. Anti-Toxoplasma IgG and IgM antibodies were measured by using the ELISA method. Also, the relationship between the infection and age, gender, education, occupation, antiretroviral status, CD4+ cell counts and some other factors of the patients were assessed. P0.05 was considered statistically significant. Results:Among the HIV-positive patients, 40.8%(157/358) and 2.6%(10/358) patients were positive for anti-T. gondii IgG and IgM antibodies, respectively. The mean CD4+ count in the patients with HIV was 327 cells/μL. A significant correlation was observed between the toxoplasmosis infections with the age group(P0.05). Nevertheless, no statistically significant difference was found between gender, living area, educational level, occupational, marital status, antiretroviral status, prophylaxis, CD4+ cell count and toxoplasmosis. Conclusions: This study revealed that the patients with HIV infection were at the high risk of developing toxoplasmosis disease especially those patients who do not receive antiretroviral therapy and prophylaxis. The development and use of the effectiveness-based guidelines for controlling and the prevention reactivation of the latent T. gondii infection is required.     

Capsule endoscopy in diagnosis of small bowel Crohn＇s disease

AIM: To evaluate the effectiveness of wireless capsule endoscopy in patients with suspected Crohn‘s disease (CD) of the small bowel undetected by conventional modalities,and to determine the diagnostic yield of M2A Given Capsule.METHODS: From May 2002 to April 2003, we prospectively examined 20 patients with suspected CD by capsule endoscopy. The patients had the following features:abdominal pain, weight loss, positive fecal occult blood test, iron deficiency anaemia, diarrhoea and fever. All the patients had normal results in small bowel series (SBS) and in upper and lower gastrointestinal endoscopy beforethey were examined. Mean duration of symptoms before diagnosis was 6.5 years.RESULTS: Of the 20 patients, 13 (65%) were diagnosed as CD of the small bowel according to the findings of M2A Given Capsule. The findings detected by the capsule were mucosal erosions (2 patients), aphthas (5 patients),nodularity (1 patient), large ulcers (2 patients), and ulcerated stenosis (3 patients). The distribution of the lesions was mainly in the distal part of the small bowel,and the mild degree of lesions was 54%.CONCLUSION: Wireless capsule endoscopy is effective in diagnosing patients with suspected CD undetected by conventional diagnostic methods. It can be used to detect early lesions in the small bowel of patients with CD.     

Clinicopathological features and survival of patients with AIDS related non-Hodgkin's lymphoma

正Objective To analyze the clinical characteristics,pathological features and survival of patients with AIDS related non-Hodgkin’s lymphoma(ARL).Methods The clinical data of 53 ARL cases diagnosed and receiving care at Zhongnan hospital of Wuhan University were retrospectively studied,and 106 controls were enrolled as control group according to 1∶2 for paired cases and control.SPSS 13.0 package was used for statistical analy-     

Tuberculous peritonitis in children：Report of nine patients and review of the literature

AIM：To present our experience with tuberculous peritonitis treated in our hospital from 2002-2007. METHODS： We reviewed the medical records of 9 children with tuberculous peritonitis. RESULTS： Nine patients （5 boys, 4 girls） of mean age 14.2 years were diagnosed with peritoneal tuberculosis. All patients presented with abdominal distention. Abdominal pain was seen in 55.5% and fever in 44.4% of the patients. Four cases had coexisting pleural effusion and two had pulmonary tuberculosis with parenchymal consolidation. Ultrasonography found ascites with septation in 7 patients. Two patients had only ascites without septation. Ascitic fluid analysis of 8 patients yielded serum-ascite albumin gradients of less than 1.1 gr/dL. Laparoscopy and laparotomy showed that whitish tuberculi were the most common appearance. Adhesions were also seen in three cases. The diagnosis of peritoneal tuberculosis was confirmed histo-pathologically in 7 patients and microbiologically in two. Two patients had been diagnosed by ascitic fluid diagnostic features and a positive response to antituberculous treatment. All patients completed the antituberculous therapy without any complications. CONCLUSION： Tuberculous peritonitis has to be clinically suspected in all patients with slowly progressive abdominal distension, particularly when it is accompanied by fever and pain. Laparoscopy and peritoneal biopsy are still the most reliable, quick and safe methods for the diagnosis of tuberculous peritonitis.     

获得性免疫缺陷综合征患者胃黏膜组织人类免疫缺陷病毒感染分析

Objective To investigate the distribution and amount of human immunodeficiency virus (HIV) infection in gastric mucosa from untreated acquired immune deficiency syndrome (AIDS) patients and highly active antiretroviral therapy (HAART) treated patients.Methods Thirty-five AIDS patients (14 untreated patients and 21 patients receiving HAART) and 10 HIV-1 seronegative patients with gastrointestinal symptoms were enrolled and examined by upper endoscopy.The labeled HIV-1 double-stranded cDNA probe was a PCR product corresponding to the LTR and gag gene of the HIV-1 genome.HIV in gastric mucosal tissues from AIDS patients was detected using in situ hybridization (ISH) and compared with that in peripheral blood mononuclear cells (PBMC).Results ① No obvious character was found in gastrointestinal symptoms,endoscopy examination and pathology results of AIDS patients.② The expression of HIV gene was mainly detected in the gastric mucosal mononuclear cell (MMC).Other cells were also observed with HIV expression including mucosal epithelial cells,gland epithelial cells and interstitial cells.③There was no difference in HIV expression between sinus ventriculi and gastric body.④ HIV gene expression from AIDS patients was (1.97±3.25)% in gastric mucosa,no difference in HIV gene expression between two groups (P＞0.05).⑤ HIV gene expression in PBMC smear from AIDS patients was (12.38 ± 9.17)%.HIV expreesion in PBMC from patients who had received HAART for 1-4 years were markedly lower than that from patients who had not received HAART (P＜0.05).Conclusions The gastric mueosa is one of HIV infected sites.The potential effect of HAART on the decrease of HIV infected cells in gastric mucosa was unsatisfactory.     

获得性免疫缺陷综合征患者胃黏膜组织人类免疫缺陷病毒感染分析

Objective To investigate the distribution and amount of human immunodeficiency virus (HIV) infection in gastric mucosa from untreated acquired immune deficiency syndrome (AIDS) patients and highly active antiretroviral therapy (HAART) treated patients.Methods Thirty-five AIDS patients (14 untreated patients and 21 patients receiving HAART) and 10 HIV-1 seronegative patients with gastrointestinal symptoms were enrolled and examined by upper endoscopy.The labeled HIV-1 double-stranded cDNA probe was a PCR product corresponding to the LTR and gag gene of the HIV-1 genome.HIV in gastric mucosal tissues from AIDS patients was detected using in situ hybridization (ISH) and compared with that in peripheral blood mononuclear cells (PBMC).Results ① No obvious character was found in gastrointestinal symptoms,endoscopy examination and pathology results of AIDS patients.② The expression of HIV gene was mainly detected in the gastric mucosal mononuclear cell (MMC).Other cells were also observed with HIV expression including mucosal epithelial cells,gland epithelial cells and interstitial cells.③There was no difference in HIV expression between sinus ventriculi and gastric body.④ HIV gene expression from AIDS patients was (1.97±3.25)% in gastric mucosa,no difference in HIV gene expression between two groups (P＞0.05).⑤ HIV gene expression in PBMC smear from AIDS patients was (12.38 ± 9.17)%.HIV expreesion in PBMC from patients who had received HAART for 1-4 years were markedly lower than that from patients who had not received HAART (P＜0.05).Conclusions The gastric mueosa is one of HIV infected sites.The potential effect of HAART on the decrease of HIV infected cells in gastric mucosa was unsatisfactory.     

艾滋病合并巨细胞病毒感染23例临床分析

目的 探讨AIDS合并巨细胞病毒(CMV)感染的临床特点、治疗转归和外周血T淋巴细胞亚群变化情况.方法 回顾性分析1985～2005年北京协和医院收治的96例AIDS患者,对其中23例CMV感染患者的临床特点、外周血T淋巴细胞亚群、血清学指标、治疗及预后情况进行分析.结果 23例合并CMV感染的AIDs患者中,临床表现为:发热(18例)、咳嗽(11例)、胸闷(9例)、腹泻(8例),13例出现CMV视网膜炎,其中7例以视力下降、视物模糊等眼部症状为首发表现.18例合并肺孢子菌肺炎、结核等多种机会性感染.15例(65.2%)CMV血清学阳性,CMV pp65的阳性率为43.5%,特异性CMV IgM抗体的阳性率为30.4%.CMV感染组的CD4+ T细胞数量[14(4,39)个/μl]明显低于非CMV感染组[48(12,128)个/μl],P=0.005;CD8+CD38+T细胞比例高于非CMV感染组.结论 CMV感染多发生于晚期AIDS患者,当AIDS患者的CD4+细胞<100个/μl时,应常规检测CMV pp65抗原和特异性IgM抗体,筛查眼底;若青壮年患者以发热、视力下降、视物模糊等就诊,应警惕AIDS合并CMV感染的可能.     

Human immunodeficiency virus recovery from bronchoalveolar lavage fluid in patients with AIDS

We cultured bronchoalveolar lavage fluid for the human immunodeficiency virus (HIV) from 23 consecutive patients with acquired immunodeficiency syndrome (AIDS) and pulmonary symptoms. We also included a nonconsecutive AIDS patient with recent worsening of respiratory symptoms who had had lymphocytic interstitial pneumonitis (LIP) diagnosed six months earlier. Infectious HIV was present in the cellular fraction from two of the 23 consecutive patients and in the patient with LIP. No virus was isolated from the cell-free portion of the centrifuged fluids. The patients from whom HIV was cultured were not distinguishable from other patients by clinical, radiographic, or laboratory data, and their subsequent course did not appear to differ. One patient with a positive HIV culture had organizing pneumonia without evidence of LIP at autopsy three weeks after lavage. This study demonstrates that HIV can be cultured from cells obtained by bronchoalveolar lavage and suggests that its presence is not associated with a single specific pulmonary histologic pattern.     

Effect of highly active antiretroviral therapy on viral burden in the lungs of HIV-infected subjects

BACKGROUND: Human immunodeficiency virus (HIV) is readily detectable in the lungs of infected subjects and leads to an accumulation of CD8(+) lymphocytes in the alveolar space. Although highly active antiretroviral therapy (HAART) is effective in reducing viremia, less is known about its effect on tissue compartments. The AIDS Clinical Trials Group Protocol 723 Team evaluated the effect of HAART on lung viral load and cellular constituents. METHODS: Bronchoalveolar lavage (BAL) fluid and blood were collected before initiation of HAART and again at 4 and 24 weeks after initiation of therapy. The BAL cell differential was determined, lymphocyte phenotyping was performed, and acellular BAL fluid, plasma HIV RNA load, and BAL cell and peripheral blood mononuclear cell HIV RNA and DNA loads were measured. RESULTS: HAART induced a rapid decrease in HIV that was detectable in acellular BAL fluid and a slower decrease in the HIV RNA and DNA loads in BAL cells. HAART was associated with a significant decrease in the absolute number and percentage of CD8(+) alveolar lymphocytes. There was a significant correlation between residual BAL cell DNA at 24 weeks and the absolute number of CD4(+) lymphocytes in the alveolar space. CONCLUSION: HAART is associated with a significant decrease in the pulmonary HIV burden and a return of alveolar cellular constituents to normal.     

Phenotypical and functional analysis of bronchoalveolar lavage lymphocytes in patients with HIV infection

The lungs of patients with acquired immunodeficiency syndrome (AIDS) are frequently affected by opportunistic and nonopportunistic infections and pulmonary localizations of Kaposi's sarcoma. The aim of this study was to verify whether, in patients with human immunodeficiency virus (HIV) infections, immunologic pulmonary abnormalities set the stage for the lung complications. For this purpose, a phenotypic and functional characterization of lymphocytes recovered from the bronchoalveolar lavage (BAL) fluid of 24 patients with clinical symptoms and signs of HIV infections was performed (six patients with constitutional disease, five patients with neurologic manifestations, and 13 patients with full-blown AIDS). Our data showed that (1) in patients with HIV, the percentage and absolute number of pulmonary CD8 cells were significantly increased over those in control subjects (in 25% of these patients, mostly with full-blown AIDS, CD8 cells sustained an alveolitis); (2) lung CD4 cells were reduced in percentage but not in absolute number, with the exception of patients with AIDS in whom a significant decrease of the absolute number of BAL CD4 cells has been found (further phenotypic analysis of CD4 lymphocytes showed a reduction of the expression of T4A, B, and E with respect to the T4, T4C, T4D, and T4F epitopes); (3) although the number of BAL cells bearing NK-related determinants was increased, we were unable to demonstrate any in vitro natural killer cell activity. We suggest that the impairment of a proper NK activity in the lungs of these patients might be central to the mechanisms leading to the in situ immunodeficiency state and to the pulmonary complications characterizing AIDS.     

Preferential recruitment of phagocytes into the lung of patients with advanced acquired immunodeficiency syndrome and tuberculosis

Limited data are available on the cellular and immunocytological characteristics of bronchoalveolar lavage (BAL) fluid in individuals infected with the human immunodeficiency virus (HIV) and pulmonary tuberculosis (TB). The immune host response against tuberculosis in early HIV-infection may differ from that in later stages of HIV disease, as is strongly suggested by different clinical and radiographic patterns. We studied the cellular elements in the lungs of 15 HIV-infected patients with advanced immunosuppression and pulmonary tuberculosis (TB/AIDS). The findings were compared with data from four other groups: 1) 15 HIV-seronegative patients with pulmonary TB; 2) 12 HIV-seropositive TB patients without previous AIDS-defining illnesses and with CD4+ >200 cells mm(-3); 3) five AIDS patients without pulmonary lesions; and 4) five healthy controls. BAL fluid and differential cell counts, as well as lymphocyte subsets, were determined. Despite a low CD4/CD8 ratio, the TB/AIDS group had a higher absolute number of CD8+ lymphocytes in the BAL fluid than the other groups. Alveolar macrophages and neutrophils were significantly increased in TB/AIDS patients compared to control groups. The number of eosinophils was increased in TB/HIV--patients but not in TB/AIDS patients. We conclude that tuberculosis in late stage HIV-infected patients has a distinct inflammatory cell profile, suggesting an enhanced compensatory mechanism that amplifies the unspecific inflammatory reaction.     

Reversed helper/suppressor T-lymphocyte ratio in bronchoalveolar lavage fluid from patients with breast cancer and Pneumocystis carinii pneumonia.

Pneumocystis pneumonia (PCP) usually occurs in patients with hematologic malignancies and acquired immunodeficiency syndrome (AIDS). Patients with solid tumors represent a very small fraction of the reported cases of PCP. Over an 18-month period, PCP was diagnosed in three patients who had received radiation and chemotherapy for breast cancer. In all three patients, there was no serologic or clinical evidence of AIDS. Direct staining of bronchoalveolar lavage fluid (BAL) revealed Pneumocystis carinii, and cellular analysis of BAL revealed an increased percentage of lymphocytes with reversed helper/inducer:suppressor/cytotoxic T-cell (CD4:CD8) ratio. Because decreased CD4:CD8 ratio in BAL is commonly accepted as findings consistent with hypersensitivity pneumonitis and AIDS, we conclude that similar findings in patients without AIDS are not specific for hypersensitivity pneumonitis, and P. carinii should be ruled out in the appropriate clinical setting.     

HIV and cytomegalovirus viral load and clinical outcomes in AIDS and cytomegalovirus retinitis patients: Monoclonal Antibody Cytomegalovirus Retinitis Trial

OBJECTIVE: To determine the association of cytomegalovirus (CMV) viremia with mortality and CMV retinitis progression in newly diagnosed and relapsed CMV retinitis. DESIGN: Ancillary study of a randomized, placebo-controlled, phase III clinical trial. PATIENTS: A total of 83 patients with AIDS and CMV retinitis, enrolled during the first phase of the Monoclonal Antibody Cytomegalovirus Retinitis Trial, were administered MSL-109 or placebo as adjuvant therapy for CMV retinitis. MAIN OUTCOME MEASURE(S): Mortality and CMV retinitis progression. RESULTS: Treatment with MSL-109 did not predict either progression of CMV retinitis or mortality. Detection in plasma CMV DNA at baseline predicted mortality, but CMV antigenemia did not. CMV DNA was a better predictor of mortality than a high HIV viral load. Neither CMV DNA nor antigenemia predicted the progression of CMV retinitis. Among newly diagnosed patients, there was a decline in the proportion with detectable CMV viral load and CMV antigenemia in response to anti-CMV therapy. However, there was a rebound in CMV viral load to 25% and CMV antigenemia to 54.6% at 6 months. In relapsed patients, anti-CMV therapy was not associated with a change in the percentage with detectable CMV-DNA or CMV antigenemia over time. CONCLUSION: In patients with AIDS and CMV retinitis, the detection of plasma CMV DNA was associated with a higher risk of mortality than was a high HIV viral load. Anti-CMV therapy provided a transient reduction in CMV viremia in newly diagnosed but not relapsed patients with CMV retinitis. Adjuvant therapy with MSL-109 was ineffective in clearing CMV-DNA and CMV antigen from the plasma.     

Cytomegalovirus-associated chorioretinitis after liver transplantation: case report and review of the literature.

A cytomegalovirus (CMV) donor positive/recipient negative liver transplant recipient developed CMV syndrome with presumed colitis 2 weeks after discontinuing the standard 3 months of valganciclovir prophylaxis. Treatment with intravenous ganciclovir (GCV) reduced, but did not clear, CMV replication. A CMV UL97 mutation (M460V) conferring GCV resistance was identified. Reduction of immunosuppression was followed by rapidly rising lymphocyte counts as well as by clearance of CMV viremia and of clinical symptoms. However, bilateral chorioretinitis was diagnosed 2 weeks later and treated with foscarnet and cidofovir. Then, right eye vitritis occurred necessitating vitrectomy due to a partially rhegmatogeneous retinal detachment. Because chorioretinitis-vitritis after rising lymphocyte counts and clearance of CMV viremia was strongly suggestive of an immune reconstitution syndrome (IRS)-like disease, we investigated CMV-specific T-cells in the peripheral blood available during follow-up. We found strong CD8(+) but only low CD4(+) T-cell responses (4.77% vs.<0.1%) to the CMV immediate early pp72, while responses to CMV-lysate or CMV-pp65 (CD4(+) <0.01%; CD8(+)<0.01%) were low. Over 16 weeks of follow-up, pp72-specific CD8(+) responses declined, while responses to pp65 gradually increased (CD4(+) 0.16%; CD8(+) 0.76%) indicating a slowly adapting CMV-specific cellular T-cell response. Review of 12,653 published liver transplant patients identified only 14 (0.1%) reported cases of CMV-associated chorioretinitis at a median 41.7 weeks post transplant. CMV-associated opthalmologic complications late post transplantation may possibly involve 2 different entities of cytopathic retinitis and IRS-like chorioretinitis-vitritis.     

Decrease of cytomegalovirus replication in human immunodeficiency virus infected-patients after treatment with highly active antiretroviral therapy.

Cytomegalovirus (CMV) viremia, as measured by a hybrid capture assay, was used to measure the effectiveness of "immune reconstitution" in human immunodeficiency virus (HIV)-infected subjects treated with highly active antiretroviral therapy (HAART). Of the 28 enrolled patients (mean age, 38 years), 86% were male and 68% were antiretrovirally naive. Of the 23 patients who returned for follow-up, baseline median characteristics were 4.1 log10 CMV DNA copies/106 white blood cells (WBCs), 5.1 log10 HIV RNA copies/mL, and 35 CD4 cells/mm3. After initiation of HAART, median log10 CMV DNA copies/106 WBCs at means of 33, 87, and 385 days were 4.0, 3.3, and 2.5, respectively. Median log10 HIV RNA levels declined from 5.1 to 1.7 at 385 days with a commensurate rise in median CD4 T cells to 166/mm3. Immune reconstitution secondary to HAART results in a significant and progressive decline in CMV viremia in the absence of specific anti-CMV therapy.     

艾滋病合并耶氏肺孢子虫(菌)肺炎的实验室诊断

采用吉氏染色法检查艾滋病患者有耶氏肺孢子虫(菌)肺炎临床表现者痰液和支气管肺泡灌洗液(BALF)中的耶氏肺孢子虫(菌)。抽取部分留痰患者(500例)血液,检测CD4+淋巴细胞。结果显示,痰液标本耶氏肺孢子虫(菌)的阳性率(46.8%,845/1 806)显著低于BALF标本(55.8%,106/190)(P<0.05)。耶氏肺孢子虫(菌)阳性患者有临床症状的比例(96.6%,816/845)显著高于阴性者(64.0%,615/961)(P<0.05)。患者血液中CD4+淋巴细胞数量越少,耶氏肺孢子虫(菌)阳性率越高,CD4+细胞数量>200×106/L组、200×106/L～100×106/L组和<100×106/L组的耶氏肺孢子虫(菌)阳性率分别为12.0%(6/50)、39.0%(39/100)和54.6%(191/350)(P<0.05)。吉氏染色法是较好的检查耶氏肺孢子虫(菌)的方法,简单易行,容易推广,但需积累经验。