艾滋病抗病毒治疗后机会感染的变化和分布状况

目的探讨艾滋病(AIDS)抗病毒治疗后机会感染疾病谱的变化及分布状况。方法采用回顾性分析的方法,对2006年9月-2008年12月期间,在郑州市第六人民医院接受门诊及住院治疗的128例HIV/AIDS病人,抗病毒治疗前后机会感染发生情况进行总结分析。结果 (1)128例HIV/AIDS病人中,高效抗反转录病毒疗法(HAART)治疗3-12月期间共发生100例次机会感染,主要为呼吸系统(46.09%)和消化系统(11.72%)感染,其中前4位机会感染是细菌性肺炎(29.69%)、肺结核(9.38%)、口腔念珠菌感染(7.81%)、带状疱疹(3.91%);与HAART治疗前相比,治疗后机会感染中细菌性肺炎、肺结核占绝大多数(86.46%),存在一定比例的口腔念珠菌感染和带状疱疹,AIDS晚期常见的机会感染如肺孢子菌肺炎、感染性腹泻及消耗综合征、中枢神经系统病变发病明显减少。(2)128例HIV/AIDS病人HAART治疗前机会感染发病率为80.47%,治疗后3-6月时下降至28.13%,治疗6-12月时为25.89%,3组相比差异有统计学意义(P<0.05)。HAART治疗后同时合并多种机会感染的病例减少。结论 HAART治疗后的机会感染发病率明显下降,机会感染疾病谱较治疗前有所不同,同时合并多种机会感染的几率减少。

The change and the spectra of opportunistic infections in AIDS patients after antiretroviral treatment

Objective To explore the change and the spectra of opportunistic infections in AIDS patients after antiretroviral treatment.Methods One hundred and twenty eight ambulatory and hospitalized HIV/AIDS cases were retrospectively analyzed to summarize the characteristics of opportunistic infections occurring pre and post highly active anti-retroviral treatment(HAART)in the department of infectious disease of our hospital,from September of 2006 to December of 2008.Results(1) The 128 HIV/AIDS patients experienced HIV-related opportunistic infections for 100 case-episodes after HAART for 3-12 months,involving respiratory system(46.09%) and gastrointestinal system(11.72%).The top 4 common opportunistic infections were as follows:bacterial pneumonia(29.69%),pulmonary tuberculosis(9.38%),oral candidiasis(7.81%),herpes zoster(3.91%).After HAART,the incidence rate of bacterial pneumonia and pulmonary tuberculosis accounted for the majority(86.46%),oral candidiasis and herpes zoster had some proportion,pneumocystis jiroveci pneumonia,infective diarrhea,wasting syndrome and central nervous system disease were decreased significantly.(2) The incidence rate of opportunistic infections in 128 HIV/AIDS patients was 80.47% before HAART,the rate decreased to 28.13% after treatment for 3-6 months and was 25.89% after treatment for 6-12 months;the statistically significant difference was found between three groups.The number of cases post treatment complicated with multiple opportunistic infections was obviously decreased.Conclusion The incidence rate of opportunistic infections and patients with multiple opportunistic infections decreased significantly in HIV/AIDS patients after antiretroviral treatment.The spectra of opportunistic infections were different between pre and post treatment.