Clinical parameters and outcomes of Pneumocystis jiroveci pneumonia in non-HIV/AIDS patients

Pneumocystis jiroveci pneumonia （PCP） is one of the most serious and potentially fatal infectionsencountered in immonosuppressed patients. It remains the most common cause of pulmonary morbidity and mortality in patients infected with human immunodeficiency virus （HIV）.     

Activation and coreceptor expression of T lymphocytes induced by highly active antiretroviral therapy in Chinese HIV/AIDS patients

Background At the end of 2005, 650 000 people lived with human immunodeficiency virus type-1 (HIV-1) in China, of whom 75 000 were AIDS patients. Many AIDS patients received highly active antiretroviral therapy (HAART) supported by the “China CARES” program but the immune responses of HAART were seldom reported. This study investigated the effect of HAART on the activation and coreceptor expression of T lymphocytes in Chinese HIV/AIDS patients and evaluated its effect on immune reconstitution. Methods Seventeen HIV/AIDS patients were enrolled and three-color-flow cytometry was used to detect the activation of HLA-DR CD38 and the coreceptor CCR5, CXCR4 expression on T lymphocytes in whole blood samples taken from the patients before and after 3- or 6-month HAART.Results The activation percents of CD4(+), CD8(+) T lymphocytes were significantly higher before therapy than the normal controls (HLA-DR/CD4: 40.47±18.85 vs 11.54±4.10; CD38/CD4: 81.34±10.86 vs 53.34±11.44; HLA-DR/CD8: 63.94±12.71 vs 25.67±9.18; CD38/CD8: 86.56±11.41 vs 58.84±6.16, all P<0.01). After 6-month combined antiretroviral treatment, the activation of T lymphocytes in HIV/AIDS patients was significantly decreased (HLA-DR/CD4: 28.31±13.48; CD38/CD4: 69.88±12.64; HLA-DR/CD8: 46.56±18.64; CD38/CD8: 70.17±14.54, all P<0.01 compared with the pre-treatment values). Before the treatment, CCR5 expression on CD8(+) T lymphocytes was up-regulated while CXCR4 expression on CD8(+) T lymphocytes downregulated in HIV/AIDS patients compared with the normal controls (CD8/CCR5: 70.91±10.03 vs 52.70±7.68; CD8/CXCR4: 24.14±11.08 vs 50.05±11.68, all P<0.01). After 6-month HAART, CCR5 expression on CD8(+) T lymphocytes significantly decreased (56.35±12.96, P<0.01), while CXCR4 expression on CD8(+) T lymphocytes increased (36.95±9.96, P<0.05) compared with the pre-treatment and the normal controls. A significant statistical relationship was observed between the expression of activation markers, CCR5 and the CD4(+) T lymphocyte counts after HAART (P<0.05).Conclusions Reduced activation of T lymphocytes and a normalization of coreceptor expression were observed in Chinese HIV/AIDS patients after HAART. Immunity can be restored in HIV/AIDS patients receiving HAART.     

Guidelines for diagnosis and treatment of HIV/AIDS in China (2005)

Acquired immunodeficiency syndrome （AIDS）, ,caused by the human immunodeficiency virus （HIV）, has become a major public health issue in China. It not only posesses formidable challenges for the health of the Chinese people, but has also influenced China＇s economic development and social stability.     

Epidemiology of Human Immuno-deficiency Virus and Quality of Life for People Living with HIV/AIDS in China

HIV/AIDS is increasing in prevalence in China and spread of infection from highly risk populations to the general populations was recognized. Despite the fact, there are still only few scientific reviews on quality of life （QOL） for people living with HIV/AIDS （PLWHAs）. However, many PLWHAs are struggling with social and psychological influences such as substances abuse, cultural beliefs, depression, stigma, poverty, which can affect their QOL. Public unawareness about infection and disease, willingness to seek medical care and motivation to follow therapy are indirectly influencing health outcome. In 2003 Chinese government has established the so-called the ＂Four Frees and One Care＂ policy. The policy was officially implemented from 2004 in some areas, yet to date it is not implemented nationwide. This paper discussed the epidemiology of HIV, underlying psychosocial factors affecting PLWHAs and their impact on QOL. We put forward some recommendations for stakeholders, advocacy groups, non-government organizations and Chinese government.     

HIV/AIDS cases on rise in China

China reported 18 543 new cases of HIV carriers and 4314 cases of full-blown AIDS in the first half of this year.[第一段]     

HIV/AIDS, Gender Equality and Reproductive Health

At the beginning of my speech, I would like to thank the Partners in Population and Devel- opment for offering us an ideal forum to share experience and discuss ways to move forward concepts prompted by ICPD Cairo conference. I would like to talk specifically about the threat from HIV/AIDS. First, I want to stress the importance of gender issues. All my experience shows me the vital contribution of women to development, and the importance of gender equality for ending the HIV/AIDS pa…     

First national guidelines will help better control HIV/AIDS in China

Acquired immunodeficiency syndrome （AIDS） was first recognized in the United States in the Summer of 1981, when the US Centers for Disease Control and Prevention （CDC） reported the unexplained occurrence of Pneumocystis cariniJ pneumonia （PCP） in 5 cases and Kaposi＇s sarcoma in 26 cases of previouly healthy homosexual men in Los Angeles and New York. Within months, the disease became recognized in male and female intravenous drug users （IDU） and soon after in recipients of blood or IDV transfusions and in hemophiliacs.     

The TCM Remedies for Treatment of AIDS——A Clinical Report of 60 Cases

Objective: To evaluate the clinical effects of TCM remedies in treatment of acquired immune deficiency syndrome (AIDS). Method: 60 cases of AIDS or AIDS-related complex (ARC) were divided into four different TCM patterns and treated accordingly. Results: Of the 60 cases, 52 patients (86.7%) experienced remarkable improvement in general symptoms and lab findings, including virus loading and CD4 T lymphocyte count. Conclusion: The TCM remedies could definitely improve the symptoms and signs of AIDS or ARC, enhance the immune function, decrease the possibility of contracting opportunistic infection, improve the life quality, and prolong the survival period, with no apparent toxic and side effects.     

HIV/AIDS Knowledge, Attitudes and Behaviors among Undergraduate Students in China

Objective To assess students＇ knowledge, practices on HIV/AIDS, to see what their attitudes are towards the pandemic of HIV/AIDS and to identify the differences of their knowledge, attitudes, and practices regarding HIV/AIDS by gender, major, monthly expenditure. Methods 259 undergraduates from different faculties were randomly selected through stratified cluster sampling. A self-designed questionnaire was utilized to collect data of this study. Results Our findings suggested that the majority of undergraduates had a moderate level of HIV/AIDS knowledge, and tolerant attitudes towards people with HIV/AIDS. Boys held more tolerant and positive attitudes towards people with HIV/AIDS than girls. Students majoring in Medicine performed better （more knowledgeable and tolerant） than non-medical students. Differences between students with various monthly expenditures were found. Students with monthly expenditures of 300-599 Yuan were shown to know more about HIV/AIDS, practiced safer behavior regarding HIV/AIDS and held more positive attitudes towards HIV/AIDS people than students whose expenditures were above 600 Yuan. Conclusion Based on the results of our study, we are convinced that there is still room for improvement： students＇ knowledge about HIV/AIDS was uneven, and their knowledge was not correlated with safer sexual behavior. Therefore, developing and maintaining safer sexual behavior will be emphasized as well as spreading information with regard to HIV/AIDS and its prevention.     

Overview of HIV drug resistance and its implications for China

Since the initiation of China＇s nationwide free antiretroviral therapy （ART） in 2002, the availability of highly active antiretroviral therapy （HAART） in China has increased dramatically. HAART has been proven to prolong survival and control HIV disease progression. At the same time, experience in developed countries indicates that the high mutation rate of the virus in the presence of HAART is associated with drug resistance and diminished efficacy. The increase in HAART availability and use in China therefore also comes with the potential for increased resistance. Transmission of drug-resistant strains to individuals who have never been exposed to ART is on the rise. Moreover, studies have shown that new infections by drug-resistant virus result in suboptimal response to ART. With the rapid scale up of ART in China in recent years, the prevalence of HIV drug resistance will likely increase, posing a major public health concern in China. This review article provides an overview of ART resistance, the current worldwide trends in HIV drug resistance, the effect of HIV drug resistance in clinical management, and the implications for China＇s HIV treatment and care.     

成人中枢神经系统白血病42例临床总结

目的 探讨急性白血病患者合并中枢神经系统白血病（CNSL）的临床特点.方法 回顾性分析了42例成人白血病患者合并CNSL的临床资料.结果 在42例成人CNSL患者中,急性淋巴细胞白血病（ALL）26例,急性非淋巴细胞白血病（ANLL）14例,慢性粒细胞白血病急性变2例.目前死亡29例,失访5例,存活8例.结论 白血病的各个亚型均可发生CNSL,预后较差,临床应重视其预防及治疗.     

分析重庆市HIV/AIDS患者合并HBV、HCV感染状况

目的 分析重庆市艾滋病病毒感染者(HIV)和获得性免疫缺陷综合征(acquired immunedeficiency syndrome,AIDS)患者(简称HIV/AIDS患者)合并感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)状况.方法 利用《艾滋病综合防治系统——抗病毒治疗管理》数据库,回顾收集重庆市2004-2015年HIV/AIDS治疗患者基本情况和HBsAg、Anti-HCV实验室检测结果,利用SPSS 19.0统计软件进行统计分析.结果 截至2015年12月31日,重庆市HIV/AIDS患者中HBsAg和(或)Anti-HCV总检测率55.1％ (11 231/20 397),其中HBsAg和Anti-HCV都进行检测的患者有9 307例.HIV/HBV、HIV/HBV/HCV、HIV/HCV合并感染的比例分别为9.8％、0.9％、4.5％.HIV/HCV合并感染在30 ～ 45岁年龄段构成比最高;HIV/HBV合并感染在男性中构成比最高,与HIV单纯感染组比较,差异均具有统计学意义(P＜0.05).HIV/HBV合并感染及HIV单纯感染均在性传播中构成比最高,差异无统计学意义(P=0.177);HIV/HCV和HIV/HBV/HCV合并感染在静脉吸毒中构成比最高,与HIV单纯感染比较,差异具有统计学意义(P＜0.05).主城9区中HIV/AIDS患者及合并感染患者比例最高.合并感染组病死率均高于HIV单纯感染组,HIV/HBV/HCV组病死率最高.结论 重庆市HIV/AIDS患者中HBsAg、Anti-HCV检测率较低,不同感染模式具有不同的流行病学特征,且合并感染的病死率较高,需要进一步加强对重庆市HIV/AIDS患者中HBV、HCV合并感染检测率和治疗情况的管理.     

210例HIV/AIDS患者淋巴细胞计数与机会性感染相关分析

目的 分析HIV/AIDS患者总淋巴细胞计数(TLC)与机会性感染的关系,为HIV/AIDS患者机会性感染的治疗及一级、二级预防提供参考依据.方法 对2009年6月至2011年5月210例HIV/AIDS患者的淋巴细胞及出现的机会性感染进行分析.将患者分为TLC＞1 300个/μl组(G1组)和TLC≤1 300个/μl组(G2组),比较两组患者机会性感染发生率的差异.结果 210例HIV/AIDS患者机会性感染的总感染率为86.7％,主要的机会性感染为口腔念珠菌感染(56.2％)、细菌性肺炎(46.7％)、肺结核(42.4％)、败血症(21.4％)、感染性腹泻(20.5％).G2组患者机会性感染的发生率为93.6％,高于G1组患者(55.3％),差异有统计学意义(P＜0.05);随着TLC的下降,患者发生机会性感染的机率增高.结论 HIV/AIDS患者机会性感染的发生率高,TLC是HIV/AIDS患者发生机会性感染的独立危险因素.因此,应定期监测HIV/AIDS患者TLC,加强患者机会性感染的一级和二级预防.     

66例艾滋病合并肺结核与单纯肺结核临床对照分析

目的:探讨艾滋病合并肺结核病的临床特征。方法:将诊治的艾滋病合并肺结核病并完成治疗及随访的66例患者作为观察组(A组),以同期住院的HIV(-)单纯肺结核患者72例为对照组(B组)进行回顾性分析。结果:A组痰抗酸杆菌阳性率7例,10.61%,显著低于B组,21例,29.17%(P=0.007);A组发热和体重下降较B组更常见,而咳嗽和咯血较B组少见;A组合并肺外结核较B组多见,A组淋巴系统较B组常发生结核病变,A组全身血液播散性结核病的发病率明显高于B组;肺结核的X线、CT表现为弥漫性浸润或粟粒性阴影的,A组多于B组,而A组影像学空洞率显著低于B组;抗痨疗效A组显著低于B组;外周CD4+T淋巴细胞数与结核严重程度相关。结论:HIV(+)/AIDS患者合并肺结核临床表现不典型,结核分枝杆菌检出率低,肺结核的X线、CT表现不典型,抗痨疗效较差。     

HIV/AIDS患者合并耳鼻咽喉头颈外科肿瘤的临床分析(附8例报告)

目的 总结HIV/AIDS患者合并耳鼻咽喉头颈外科相关肿瘤的临床表现及治疗情况.方法 对我科2012年11月至2017年4月收治的HIV/AIDS合并耳鼻咽喉头颈外科肿瘤的8例患者进行回顾性分析,总结其临床表现、围术期免疫指标、手术方式及后续治疗,复诊情况及有无复发,追访患者转归.结果 本组中1例颞骨巨细胞瘤,1例鼻腔鼻窦鳞状细胞癌合并内翻性乳头状瘤、霉菌性鼻窦炎,1例鼻腔鼻窦内翻性乳头状瘤,1例喉部卡波西肉瘤,2例喉鳞状细胞癌,1例甲状腺微小乳头状癌伴颈淋巴结转移,1例鼻腔NK/T细胞淋巴瘤.所有患者均实施手术治疗,其中5例有效,1例死亡,1例失访,1例无效.结论 HIV/AIDS合并耳鼻咽喉头颈外科肿瘤患者,其诊断、治疗与正常患者无显著差异,该类患者应予以积极治疗,对于延长患者的生存时间和提高其生活质量都有很大的作用.     

Purified protein derivative skin testing on HIV/AIDS patients and logistic regression analysis of its risk factors

Objective： To understand the reactivity of purified protein derivative skin test（PPD test） in HIV-infected persons and to determine the influential factors associated with PPD. Methods： 174 HIV/AIDS patients registered in the local center for disease control and prevention（CDC） participated this study from April to June in 2006. Questionnaire,CD4 count and thoracic roentgenogram were performed for all participants. Results： In this study, response rate of questionnaires was 83.65%. The majority of these participants had a different degree of immunodeficiency that accounted for 93.64%. Female patients had a higher CD4 count than that of males. The total positive rate of PPD was 38.15%. Analysis of single factor in our study indicated that CD4 count, previous tubereulosis history, tuberculosis contact history and thoracic roentgenogram manifestation of patients were related to their PPD diameters. Further analysis of multiple factors also supports the previous conclusion that CD4 count and previous tuberculosis history of patients were risk factors in the PPD test. Conclusion： The PPD test of HIV/AIDS patients could be affected by several factors. For persons infected with HIV, the confirmation of latent tuberculosis infection （LTBI） should be considered the combination effect of previous MTB infection and body cellular immune function.