摘要
目的 探讨HIV-1急性感染者临床表现、免疫学及病毒学特征,提高HIV-1急性感染诊断水平。方法 回顾性分析2012年1月至2017年6月期间在广州市第八人民医院住院并诊断为急性HIV-1感染者的临床资料。结果 共44例患者纳入研究,当中男性为主(86.4%),感染途径以男男同性传播更常见(59.1%),主要临床症状和体征包括发热(84.1%)、淋巴结肿大(56.8%)等,部分患者可出现中枢神经系统症状(15.9%)。常见合并疾病或病变包括肺部病变22例(50.0%)和口咽念珠菌感染10例(22.7%)。主要实验室结果异常为白细胞降低(22.7%)、CD4+T淋巴细胞计数下降(平均268个/μl)和CD4+/CD8+比例倒置(86.4%)。血浆HIV RNA载量平均(5.9±0.9)lg拷贝/ml,且HIV RNA载量>6lg拷贝/ml患者组较HIV RNA载量≤6lg拷贝/ml组CD4+T细胞计数显著下降(t=-3.724,P=0.001)。结论 急性HIV-1感染者临床表现多样且可合并多种机会性感染,病毒水平高。
Objective To investigate the clinical,immunological and virological characteristics of HIV-1 infected patients in the acute phase,for the sake of improving the diagnosis of acute infection with HIV-1.Methods We retrospectively analyzed the clinical manifestation and laboratory data of patients with acute HIV-1 infection who were admitted to the Center of Infectious Diseases,Guangzhou Eighth People’s Hospital from January 2012 to June 2017.Results Forty-four patients were enrolled into the study,86.4%of them were male.59.1%patients were homosexually transmitted.Clinical symptoms and signs mostly consisted of fever(84.1%),lymphadenopathy(56.8%)and so on,while 15.9%patients had central nervous system symptoms.Most common opportunistic infection included lung infection(50.0%)and oropharyngeal candidiasis(22.7%).Leucopenia(10 patients,22.7%),and decreased CD4+T cell count(267.5 cells/μl),inverted CD4+/CD8+ratio(86.4%)was mostly seen.Compared to patients who had HIV RNA load less than 6 lg copies/ml,the group of patients who had HIV RNA load more than 6 lg copies/ml had lower levels of CD4+T cells(t=-3.724,P=0.001).Conclusions Patients with acute HIV infection have many different kinds of clinical symptoms and can be accompanied by opportunistic infection,and with high viremia.
作者
刘波
陈志敏
李凌华
廖宝林
兰芸
冯理智
张坚生
唐小平
蔡卫平
何浩岚
Liu Bo;Chen Zhimin;Li Linghua;Liao Baolin;Lan Yun;Feng Lizhi;Zhang Jiansheng;Tang Xiaoping;Cai Weiping;He Haolan(Center of Infectious Disease,Guangzhou Eighth People’s Hospital,Guangzhou Medical University,Guangzhou 510060,China;Guangzhou Institute of Infectious Disease,Guangzhou 510060,China)
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2019年第6期611-616,共6页
Chinese Journal of Experimental and Clinical Virology
基金
"十三五"艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2017ZX10202102-004-001)
广东省自然科学基金项目(2016A030310108)
国家自然科学基金项目(81672024)
广州市科技计划项目(201803040002)。
