OBJECTIVE

To investigate the spectra of opportunistic infections (OIs) in HIV/AIDS patients in China and evaluate the relation between OIs and CD(4)(+), CD(8)(+) T cell counts so as to suggest when the prophylaxis for OIs should begin.

METHODS

The clinical and immunological characteristics of 181 patients with HIV/AIDS admitted into the Department of Infectious Disease, Beijing Youan Hospital from 2002 to 2005 were retrospectively analyzed.

RESULTS

One hundred and four of the 181 HIV-positive patients experienced at least one HIV-related opportunistic infection. The most common opportunistic infections were as follows: oral candidal pharyngitis (52.9%), Pneumocystis carinii pneumonia (PCP) (31.7%), tuberculosis (21.2%), systemic mycosis (15.4%), viral herpes (12.5%) and other respiratory infections (6.7%), etc. The medians of CD(4)(+), CD(8)(+) T cell counts and CD(4)/CD(8) ratios in the patients with OIs were lower as compared with those in the patients without OIs. The patients who experienced OIs had similar CD(4)(+) T cell count with no statistical difference, no matter there was one or more than one OIs. The CD(+)(4) T cell counts lowered in accordance with increase of the number of OIs. The similar results were found in the CD(4)/CD(8) ratios. There was significant difference between CD(4)/CD(8) in patients with tuberculosis and those with PCP.

CONCLUSIONS

HIV-related OIs are easily encountered in digestive and respiratory systems of HIV/AIDS patients and it is shown that a close correlation exists between CD(4)(+) T cell count, CD(4)/CD(8) ratio and opportunistic infections. Patients with CD(4)(+) T cell count below 200 cells/microl, CD(4)/CD(8) less than 0.20 especially are at higher risk of developing opportunistic infections and they generally have diverse OIs. Our findings are helpful to predict the initiation both primary and secondary prophylaxis for OIs in HIV/AIDS patients in China.