以结节性痒疹为首发表现的艾滋病3例及文献复习

结节性痒疹是艾滋病患者较为常见的皮肤表现,是多因素导致的疾病,其皮损与非艾滋病患者相似。本文3例均为男性,临床表现为全身散在丘疹、结节、表皮剥脱、结痂伴剧烈瘙痒,淋巴细胞分类计数示CD4、CD4/CD8比值降低。HIV血清抗体初筛实验及确证实验均(+)。皮损组织病理符合结节性痒疹。2例予抗组胺药物和外用糖皮质激素软膏后症状减轻,1例放弃治疗。沙利度胺是治疗艾滋病相关性结节性痒疹最有效的药物。     

北京市HIV/AIDS患者生存质量现状及影响因素分析

目的 分析艾滋病病毒(HIV)感染者及艾滋病(AIDS)患者(简称HIV/AIDS患者)的生存质量现状,探讨相关影响因素,为提高随访管理和改善患者的生存质量提供参考.方法 使用世界卫生组织(WHO)艾滋病生存质量简表(WHOQOL-HIV BREF)和中文版艾滋病压力量表(CSS-HIV)对北京市220例HIV/AID...     

HIV相关性结节性痒疹

结节性痒疹是较常见的艾滋病皮肤表现,与艾滋病预后相关.HIV相关性结节性痒疹是多因素导致的疾病,病理生理学尚不明确,临床和皮肤病理表现及治疗与非艾滋病患者相似,表皮脱落和结痂是HIV相关性结节性痒疹最显著的特征.沙利度胺是系统治疗最为有效的药物.     

2017—2021年广西某综合医院新报告HIV/AIDS晚发现病例特征及影响因素

目的 了解2017—2021年广西某综合医院就诊人群中新报告人类免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)患者晚发现病例流行病学特征及其影响因素。方法 收集2017—2021年广西某综合医院就诊人群中新发现的HIV/AIDS患者，使用SPSS28.0软件进行描述性统计分析。结果 病例首次CD4⁺T淋巴细胞计数在1～1 284个/μL区间，53.13%(441/830)的病例首次CD4⁺T淋巴细胞计数≤200个/μL,整体晚发现率处于较高水平。不同就诊年龄、现住址、婚姻状况、民族、文化程度、感染途径、就诊类别、就诊科室以及不同临床表现病例的CD4⁺T淋巴细胞计数检测结果分布差异有统计学意义(P<0.05)。多因素分析显示，年龄31～49岁(OR=1.857,P=0.028)、有HIV临床表现(OR=6.245,P<0.001)、急诊科(OR=4.283,P=0.014)以及呼吸内科(OR=3.468,P=0.001)就诊者是晚发现的独立风险因素，同性传播(OR=0.320,P<0.001)是晚发现的...     

免疫缺陷性皮肤病

20042794　中国HIV/AIDS患者CD 4,CD 8T淋巴细胞与外周血各组份间关系的研究/肖瑶(中国疾控中心性病艾滋病预防控制中心)…//中国艾滋病性病.-2004,33(4).-221对513份艾滋病病毒/艾滋病(HIV/AIDS)患者外周血检测分析。结果显示患者CD4/CD8全部倒置,<1者达94.7%;CD 4,CD 8T淋巴细胞细胞数与外周血中血红蛋白(HGB)、淋巴细胞(LY)、淋巴细胞百分数(LY%)呈正相关,与粒细胞百分数(GR%)呈负相关。CD4/CD8与HGB、LY及血小板无显著性相关。表3参5　(杨亚琴)20042795　HIV/AIDS患者口咽部念珠菌病与CD 4,CD 8T淋巴细胞分析/…     

HIV/AIDS皮肤病变的临床分析

目的 探讨HIV/AIDS患者皮肤粘膜病变的临床特征及其与疾病进展的相关性。方法 对45例HIV/AIDS患者的皮肤病变进行临床分析,并同时检测其CD4细胞计数与HIV病毒载量。结果 45例HIV/AIDS患者中有30创(66.7％)伴有皮肤病变,其中以真菌和疱疹病毒感染引起的皮肤病最常见,各占66.7％;其次为脂溢性皮炎,占36.7％;其它类型的皮肤病占50.0％。90.0％的AIDS皮肤病变发生在CD4细胞数<200个/μl,HIV-RNA载量>4 log。而HIV/且AIDS皮肤病变随着HARRT治疗后而缓解。结论 HIV/AIDS皮肤病变发生率很高,早期诊断与治疗对于监测HIV/AIDS患者疾病的进展有重大意义。     

免疫缺陷性皮肤病

20062485HIV感染者/AIDS病人外周血淋巴细胞凋亡与CD4 T淋巴细胞水平的临床实验研究/杨忠礼(新疆维吾尔自治区医院临床检验中心),彭红,邵红…∥中国艾滋病性病.-2006,12(3).-202~20336例AIDS患者、50例HIV感染者以及54名正常对照组外周血流式细胞技术对比分析显示:淋巴细胞凋亡百分率AIDS组>HIV感染组>对照组,有显著性差异(P<0·01);CD4 T淋巴细胞水平对照组>HIV感组>AIDS组,亦有显著性差异(P<0·01)。研究结果提示HIV/AIDS患者的CD4 T淋巴细胞水平与外周血淋巴细胞凋亡具有一定程度的相关性。表1参8(杨亚琴)20062486一…     

HIV/AIDS慢性腹泻患者149例隐孢子虫感染分析

目的分析HIV/AIDS慢性腹泻患者中隐孢子虫感染情况、感染因素及流行特点,为防治隐孢子虫在AIDS患者中的感染提供依据。方法从河南省上蔡县收集AIDS慢性腹泻患者粪便标本149份,采用甲醛-乙酸乙酰沉淀法对患者粪便标本进行集卵,用改良抗酸染色法进行染色检测隐孢子虫卵囊。同时检测患者血液中CD4+T细胞计数。结果 149例HIV/AIDS慢性腹泻患者的粪便标本中24例为隐孢子虫阳性,感染率为16.11%。男性与女性患者及各年龄组感染率比较差异无统计学意义(P均>0.05);HIV/AIDS患者处于HIV无症状期、有症状期和HIV/AIDS期的隐孢子虫感染率分别为0(0/7),25.81%(16/62)和9.88%(8/81),其差异有统计学意义(P<0.05);患者CD4+T细胞水平在<200cells/μL,201～499cells/μL和>500cells/μL的隐孢子虫感染率分别为22.00%(11/50),13.68%(13/95)和0(0/21),差异有统计学意义(P<0.05)。结论 HIV/AIDS慢性腹泻患者中存在着隐孢子虫感染,中晚期患者随着病情的进展,特别是随着CD4+T淋巴细胞水平的降低,感染的危险性明显增高。     

HIV/AIDS患者外周血CD4~+ T淋巴细胞水平与巨细胞病毒感染相关性分析

目的:了解HIV/AIDS患者外周血CD4+T淋巴细胞水平与巨细胞病毒(CMV)感染的相关性。方法:采集300例HIV/AIDS患者外周血,进行CD4+T淋巴细胞水平和巨细胞病毒DNA检测。结果:300例HIV/AIDS患者中CMV DNA呈阳性者26例,阳性率为8.67%。CMV阳性患者中,有18例CD4+T淋巴细胞低于200个/μL,占CMV阳性者的69.23%。当CD4+T淋巴细胞计数低于200个/μL时,CMV感染率明显升高,与CD4+T淋巴细胞计数高于200个/μL时比较差异具有统计学意义(x2=18.42,P<0.05)。不同性别间CMV阳性率差异无统计学意义(x2=0.05,P=0.824)。年龄越小,CMV阳性率越高,各年龄组间差异具统计学意义(x2=7.93,P=0.042)。结论:在HIV/AIDS患者CD4+T淋巴细胞低于200个/μL时,应加强CMV监测。     

老年HIV/AIDS患者贫血及其影响因素分析

目的探讨老年HIV/AIDS患者贫血状况及其影响因素。方法以"艾滋病综合防治数据信息系统"和"中医药治疗艾滋病数据库"为数据来源,收集河南中医项目地区2014年老年HIV/AIDS患者贫血数据及其相关信息,采用logistic回归分析老年HIV/AIDS患者贫血的影响因素。结果本研究共纳入4 132例老年HIV/AIDS患者,1 143例老年HIV/AIDS患者合并贫血(27.66%),其中男586例,女557例(P0.01);HIV阳性9年的患者贫血危险度低于HIV阳性6年的患者;中医治疗可以降低老年HIV/AIDS患者贫血患病率,服用HAART治疗时间8年以上患者的贫血患病率是服用HAART治疗时间小于4年患者的1.68倍(P0.05);CD4细胞计数对老年HIV/AIDS患者贫血也有明显影响,CD4细胞计数越低,其贫血患病率越高。结论老年HIV/AIDS患者性别、确认HIV阳性时期,服用HAART时期、CD4细胞计数和中医药是否干预均对贫血患病率有影响。     

Mucocutaneous manifestations of HIV‐infected patients in the era of HAART in Guangxi Zhuang Autonomous Region,China

Background Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are frequently associated with diverse mucocutaneous manifestations. However, few studies of HIV/AIDS‐related mucocutaneous manifestations have been reported in China. Objective To investigate the occurrence of mucocutaneous disorders and their relationship with the degree of immunosuppression in 348 HIV‐infected Chinese patients. The influence of highly active antiretroviral therapy (HAART) on the spectrum of mucocutaneous manifestations was also evaluated. Methods A cross‐sectional study was performed on 348 HIV‐infected Chinese patients seen at the Guangxi Longtan Hospital from August 2010 to November 2010. Collected information included demographic data, HIV‐associated mucocutaneous disorders, CD4 cell count, AIDS‐defining illness and antiretroviral therapy. Results In this study, 62.9% of all patients had mucocutaneous disorders. The prevalence of mucocutaneous disorders in the patients who had received HAART was lower than in those without HAART (54.05% vs. 88.76%, P < 0.001). The prevalence of mucocutaneous disorders was higher in the patients with CD4 < 200 cells/mm³ in comparison to those with CD4 ≥ 200 cells/mm³ (P < 0.05). The most common mucocutaneous disorders were oral candidiasis (28.47%), Penicillium marneffei infection (11.49%), drug eruptions (10.06%) and pruritic papular eruption (PPE 5.75%). Oral candidiasis, P. marneffei infection and PPE were significantly more prevalent in patients with a CD4 cell count below 200 cells/mm³, but frequency of drug eruptions was not related to the level of CD4 cell counts. Patients treated with HAART had decreased rates of herpes simplex, oral candidiasis and P. marneffei infection, but increased rates of drug eruptions. Conclusions A wide range of mucocutaneous disorders were observed in HIV‐infected Chinese patients. Oral candidiasis, P. marneffei infection and PPE may be the signs of advanced HIV infection. HAART had an impact on the spectrum of HIV‐associated mucocutaneous disorders.     

服用ARV药物致低血红蛋白血症艾滋病患者生存质量及其影响因素分析

目的调查了解河南省服用抗逆转录病毒(ARV)药物致低血红蛋白血症艾滋病者生存质量状况及其影响因素。方法使用中文版WHOQOL-HIV-BREF量表,对河南省某三市县艾滋病高发农村地区71例服用ARV致低血红蛋白血症艾滋病者进行问卷调查,计算生存质量总分及各领域得分,采用单因素及多因素分析生存质量的影响因素。结果单因素方差分析结果提示性别、年龄、学历、婚姻状况、体重指数和CD4+T淋巴细胞计数对患者生存质量各领域得分及总分有一定影响。多元线性回归模型分析结果显示患者自身健康状况总的主观感受与性别相关(P<0.05);心理领域的得分与年龄及CD4+T淋巴细胞计数明显相关(P<0.05);独立性领域得分、社会关系领域得分及生存质量总分与CD4+T淋巴细胞计数明显相关(P<0.05)。结论多种因素同时影响着服用ARV致低血红蛋白血症艾滋病患者的生存质量。针对影响因素给予积极干预,特别是加强基础疾病治疗,提高CD4+T细胞计数,将有助于提高患者的生存质量。     

HIV/AIDS患者CD4~+ T细胞中CD25和CD8~+ T细胞中CD28的表达

目的探讨外周血CD4+ T细胞中CD25表达率和CD8+ T细胞中CD28表达率在HIV/AIDS患者发病中的作用。方法应用流式细胞仪荧光染色技术检测35例HIV/AIDS患者CD4+ T细胞中CD25表达和CD8+ T细胞中CD28的表达,以41名健康体检人员做对照。结果HIV/AIDS患者和健康对照组之间CD4+ T细胞中CD25表达率(27.51±4.23)%,(44.41±9.17)%,CD4+25+ T细胞占淋巴细胞的比例(2.00±1.42)%,(16.62±4.60)%,CD4+25- T细胞占淋巴细胞的比例(5.16±3.37)%,(21.03±6.19)%,CD8+ T细胞中CD28中的表达率(25.12±6.33)%,(44.24±8.61)%,CD8+28- T细胞占淋巴细胞的比例(36.85±8.98)%,(13.33±4.58)%的差异均有显著性(P<0.01),CD8+ 28+ T细胞占淋巴细胞的比例(12.31±4.14)%,(10.51±3.71)%差异无显著性(P>0.05)。结论HIV/AIDS患者CD25在CD4+ T细胞与CD28在CD8+ T细胞的表达率降低可能与HIV感染后引起的免疫缺陷有关,CD8+ CD28- T细胞的增加有助于促进HIV/AIDS患者的炎性反应和免疫激活。     

Antihistamines are superior to topical steroids in managing Human Immunodeficiency Virus (HIV)‐associated papular pruritic eruption

Papular pruritic eruption (PPE) is a frequent HIV‐comorbidity in tropical countries. Because of constant itching and social stigma, effective treatment is highly valued. In our HIV cohort in rural Tanzania with 12% prevalence of PPE, we have retrospectively analyzed responses to available treatments. Oral promethazine improved itching (P < 0.0058) and clinical scores (P < 0.032) significantly more than topical steroids. Disease activity did not correlate with CD4+ and CD8+ T cell counts and was independent of anti‐retroviral medication. Therefore, oral antihistamines are an effective first‐line treatment for PPE.     

Cytokines in the pruritic papular eruption of HIV

BACKGROUND: The immunopathogenic mechanism of the pruritic papular eruption (PPE) of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is poorly understood, and the objective of the present study was to determine the concentration of the serum cytokines interleukin-2 (IL-2), IL-4, IL-5, IL-10, IL-12, and gamma-interferon (gamma-IFN) in an attempt to recognize the pattern of CD4+/CD8+ lymphocytes occurring in this dermatosis. MATERIALS AND METHODS: The study was conducted on 11 HIV-positive PPE patients, matched for sex and age with eight HIV-infected patients with no dermatosis and 10 healthy HIV-negative individuals. Cytokines were quantified by enzyme-linked immunoabsorbent assay (ELISA) using monoclonal antibodies (R & D Systems) and the data were analyzed by the Mann-Whitney, Kruskall-Wallis, and Spearman correlation tests. RESULTS: An increased concentration of IL-2 was observed in both the HIV-positive (77.65 pg/mL, P < 0.001) and PPE (20.42 pg/mL, P < 0.05) groups when compared with the HIV-negative group (9.50 pg/mL). The IL-2 concentration was significantly higher (P < 0.05) in the HIV-positive group than in the PPE group. Similarly, the gamma-IFN concentration was higher in the HIV-positive (14.97 pg/mL) and PPE (12.67 pg/mL) groups when compared with the HIV-negative group (8.58 pg/mL). The IL-12 concentration was similar in the PPE and HIV-positive groups (1.82 and 1.68 pg/mL, respectively), but higher than in the HIV-negative group (1.17 pg/mL). The same occurred with IL-5 (17.78, 17.79, and 15.74 pg/mL, respectively). There was no significant difference in IL-4 concentration among the PPE, HIV-positive, and HIV-negative groups (10.95, 7.88, and 10.16 pg/mL, respectively), and the same was observed for IL-10 (22.41, 21.13, and 20.92, respectively). There was a negative correlation between serum gamma-IFN concentration and peripheral CD4+ lymphocyte number (r = - 0.6256) in the PPE group (P < 0.05). CONCLUSIONS: The lower levels of IL-2 and gamma-IFN and the negative correlation between gamma-IFN and peripheral CD4+ lymphocytes may indicate an early phase of immunosuppression in PPE.     

高效抗逆转录病毒疗法(HAART)对HIV/AIDS患者免疫功能的影响

目的评价高效抗逆转录病毒疗法(highly active antiretroviral therapy,HAART)对HIV/AIDS患者的疗效。方法采用HAART治疗73例HIV/AIDS患者,流式细胞仪测定治疗前后HIV/AIDS患者体内CD4+,CD8+T淋巴细胞数量,定量ELISA法检测血浆细胞因子IL-2,IL-10和TGF-β1水平。结果经HAART治疗后,CD4+T细胞数量显著回升(P(0.01),但CD8+T细胞变化不大(P(0.05)。血浆IL-10水平较治疗前明显下降(P(0.05),IL-2水平较治疗前升高(P(0.05),TGF-β1的水平显著降低(P(0.01)。结论HAART治疗HIV/AIDS患者疗效显著,对于重建免疫功能、改善体内细胞因子失调有明显效果。     

HIV感染者和AIDS患者感知歧视与心理症状的关联分析

目的 探讨HIV感染者和AIDS患者(HIV/AIDS)感知歧视与心理症状的关联.方法 对1134例HIV/AIDS患者进行问卷调查,使用自编问卷评估HIV/AIDS患者的感知歧视和心理症状(焦虑症状、抑郁症状和压力症状).使用广义线性模型来分析HIV/AIDS患者感知歧视与心理症状的关联.结果 不同性别的HIV/AI...     

微波联合咪喹莫特治疗HIV/AIDS合并肛门尖锐湿疣110例临床分析

目的探讨微波治疗联合外涂咪喹莫特乳膏治疗HIV/AIDS合并肛门尖锐湿疣的效果。方法对110例HIV/AIDS合并肛门尖锐湿疣患者治疗前进行血清CD4+T淋巴细胞数量和HIV-RNA载量检测,采用微波治疗1周后外涂咪喹莫特乳膏联合治疗,每4周复诊一次,如有复发重复治疗,并进行末次治疗后4个月的随访。结果在CD4+T淋巴细胞数量≥350×106/L的HIV患者中,20周时的治愈率为89.55%(60/67),CD4+T淋巴细胞数量<350×106/L的患者治愈率为72.09%(31/43)。结论 HIV/AIDS合并肛门尖锐湿疣治疗后易复发,在CD4+T细胞数量≥350×106/L患者中,微波结合咪喹莫特乳膏外涂治疗时间短,复发率低。     

应用流式细胞仪研究深圳地区健康成人及HIV/AIDS患者的免疫状况

目的：研究深圳地区健康人、HIV无症状感染者及AIDS患者的免疫状态，以了解艾滋病早期T细胞亚群的变化过程。方法：应用流式细胞仪三色荧光单克隆抗体（CD4－FITC／CD8－PE／CD3－PC5）检测34例正常健康成人，12例HIV感染无症状者，23例AIDS患者的外周血CD4^ 、CD8 ^ T淋巴细胞计数及CD4^ /CD8^ 比值。结果：HIV感染无症状者及AIDS患者的CD4^ 淋巴细胞及CD4^ /CD8比值均明显低于健康成人（P＜0．01）；HIV感染无症状者CD8^ T淋巴细胞明显高于正常健康人和AIDS患者（P＜0．01）；CD4^ T淋巴细胞随病程进展不断下降，AIDS患者与HIV感染无症状者之间存在着显著差异。结论：T淋巴细胞免疫状况可作为评价AIDS病程进展程度的重要指标。     

Spectrum of skin disorders in human immunodeficiency virus-infected patients in Singapore and the relationship to CD4 lymphocyte counts

BACKGROUND: Skin disorders are extremely common and cause significant morbidity in human immunodeficiency virus (HIV)-infected individuals. There are few data on their prevalence and association with CD4 counts in Asians. AIM: To evaluate the prevalence of skin disorders in ambulatory HIV-infected individuals attending a specialized skin clinic in Singapore and the association with the degree of immunosuppression. METHODS: A cross-sectional study on skin disorders in HIV-positive outpatients in the Communicable Disease Centre of Singapore was performed. The association between skin disease prevalence and CD4 count was evaluated using logistic regression. RESULTS: Ninety-six patients (male : female, 8 : 1) were enrolled. The most common mode of HIV transmission was heterosexual (75%), followed by homosexual/bisexual contacts (22%), and intravenous drug abuse (3%). The distribution of patients in terms of current CD4 cell counts was as follows: 38.5% with less than 50 x 10(6)/L, 25% with between 50 and 199/microL, and 36.5% with at least 200 x 10(6)/L. The most common skin disorder was pruritic papular eruption (PPE) of HIV infection (31 cases), followed by psoriasis (24), seborrheic dermatitis (18), xerosis (17), herpes simplex (17), and adverse drug eruptions (17). A CD4 cell count of less than 200 x 10(6)/L was significantly associated with a higher number of skin disorders (P = 0.002) and the development of psoriasis [odds ratio (OR), 8.97; 95% confidence interval (CI), 1.70-47.16; P = 0.010], PPE (OR, 3.40; 95% CI, 1.21-9.53; P = 0.020), and adverse drug eruption (OR, 5.83; 95% CI, 1.21-28.00; P = 0.028). CONCLUSIONS: A preponderance of inflammatory dermatoses and an absence of skin tumors characterized this study. A low CD4 cell count was associated with a higher number of skin disorders and an increased incidence of PPE, psoriasis, and adverse drug eruptions.