HIV/AIDS患者伴尖锐湿疣的治疗

目的观察CO2激光联合咪喹莫特乳膏治疗不同CD4+T淋巴细胞水平的HIV/AIDS患者伴尖锐湿疣的疗效。方法采用病例对照研究,普通尖锐湿疣患者为对照组、HIV/AIDS患者且CD4+T淋巴细胞计数在200 cells/μL以上为试验A组、HIV/AIDS患者且CD4+T淋巴细胞计数在200 cells/μL以下者为试验B组。3组患者均给予CO2激光联合咪喹莫特乳膏治疗。结果 CO2激光联合咪喹莫特乳膏治疗HIV/AIDS患者伴尖锐湿疣对试验A组疗效较试验B组好。试验A组患者治疗时间不低于12周,试验B组患者治疗时间大于12周;3组患者治愈率和复发率差异有统计学意义。结论对于CD4+T淋巴细胞小于200 cells/μL的HIV/AIDS患者尽快进行高效抗反转录病毒治疗(HAART),可待CD4+T淋巴细胞上升至大于200 cells/μL时,再进行治疗,可以降低尖锐湿疣的复发率,减少治疗次数。该类患者进行HAART是必要的。

Effect of carbon dioxide laser combined with imiquimod cream in the treatment of condyloma acuminatum in HIV/AIDS patients

Objective To observe the effect of carbon dioxide laser combined with imiquimod cream in treating condyloma acuminatum in HIV/AIDS patients with different levels of CD4+ T lymphocyte.Methods The design was case control study.The patients with condyloma acuminatum alone were treated as control group.The patients with both HIV/AIDS and condyloma acuminatum and CD4+ T lymphocyte > 200 cells/μL were treated as group A.The patients with both HIV/AIDS with condyloma and CD4+ T lymphocyte < 200 cells/μL were treated as group B.All patients were treated by carbon dioxide laser and imiquimod cream.Results Group A showed fewer recurrences of warts than group B.The difference was significant(P< 0.05).Similar result was observed in the cure rate.The difference between groups was also significant(P< 0.05).Conclusions Carbon dioxide laser combined with imiquimod cream was more effective in treating condyloma acuminatum and HIV/AIDS complicated with condyloma acuminatum when CD4+T lymphocyte level > 200 cells/μL compared with the patients with CD4+T lymphocyte level < 200 cells/μL.Treatment duration should be no shorter than 12 weeks in HIV/AIDS patients complicated with condyloma acuminatum and CD4+T lymphocyte level > 200 cells/μL.When CD4+T lymphocyte level < 200 cells/μL,the treatment duration should be longer than 12 weeks and HAART should be started early.Carbon dioxide laser and imiquimod cream treatment may be appropriate when CD4+T lymphocyte level recovered to >200 cells/μL.For the patients with both HIV/AIDS and condyloma acuminatum,carbon dioxide laser combined with imiquimod cream and HAART may be necessary when their CD4+T lymphocyte < 200 cells/μL.