Cao Wei, Song Xiaojing, Li Yanling, Qiu Zhifeng, Xie Jing, Han Yang, Lyu Wei, Wang Huanling, Fan Hongwei, Zhou Baotong, Liu Zhengyin, Liu Xiaoqing, Li Taisheng
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. Email:
Zhonghua Nei Ke Za Zhi. 2014 Jul;53(7):537-41.
To determine the clinical characteristics of HIV infected patients in China in order to improve early recognition and diagnosis of AIDS.
A total of 297 newly diagnosed HIV/AIDS patients were enrolled in Peking Union Medical College Hospital (PUMCH) from January 2001 to December 2012, including 19 patients of primary phase, 115 of asymptomatic phase and 163 of AIDS phase. Clinical characteristics of these patients were retrospectively analyzed.
Two hundred and nineteen out of 297 patients reported clinical symptoms with variety. The main systemic symptoms included fever (100 cases, 33.7%), weight loss (50 cases, 16.8%) and fatigue (38 cases, 12.8%). Organ involvement included mucocutaneous (67 cases, 22.6%), respiratory (62 cases, 20.9%), gastrointestinal (40 cases, 13.5%) systems. Patients in AIDS phase were more symptomatic. Seventy-three out of 173 (42.2%)patients have been referred by 2 healthcare providers at least before the diagnosis of HIV infection was confirmed. Initial diagnoses were made in Departments of Infectious Diseases (36.9%), Gastroenterology (16.4%), and Emergency (13.7%). Opportunistic infections accounted for most AIDS defining conditions (ADC), including pneumocystis jiroveci pneumonia (PCP) (36 cases, 22.1%), cytomegalovirus infection (25 cases, 15.3%) and tuberculosis (22 cases, 13.5%). Median peripheral CD(+)4 T lymphocyte count in patients with ADC were 36 cells/µl.
Common clinical presentations of HIV/AIDS included fever, weight loss, diarrhea, short of breath and mucocutaneous lesions. Opportunistic infections mainly affected respiratory and gastrointestinal system, with PCP the most common one. The diagnosis of HIV infection was delayed in most cases, suggesting that more efforts are required especially in universal education of clinicians and accurate viral detection.
确定中国HIV感染患者的临床特征,以提高艾滋病的早期识别和诊断。
2001年1月至2012年12月,共有297例新诊断的HIV/AIDS患者入住北京协和医院(PUMCH),其中急性期19例,无症状期115例,艾滋病期163例。对这些患者的临床特征进行回顾性分析。
297例患者中有219例报告有各种临床症状。主要全身症状包括发热(100例,33.7%)、体重减轻(50例,16.8%)和乏力(38例,12.8%)。器官受累包括皮肤黏膜(67例,22.6%)、呼吸(62例,20.9%)、胃肠道(40例,13.5%)系统。艾滋病期患者症状更多。173例患者中有73例(42.2%)在确诊HIV感染之前至少被2名医疗服务提供者转诊过。初始诊断在感染科(36.9%)、消化内科(16.4%)和急诊科(13.7%)做出。机会性感染占大多数艾滋病定义疾病(ADC),包括耶氏肺孢子菌肺炎(PCP)(36例,22.1%)、巨细胞病毒感染(25例,15.3%)和结核病(22例,13.5%)。患有ADC的患者外周血CD(+)4 T淋巴细胞计数中位数为36个细胞/μl。
HIV/AIDS的常见临床表现包括发热、体重减轻、腹泻、气短和皮肤黏膜病变。机会性感染主要影响呼吸和胃肠道系统,PCP最为常见。大多数情况下HIV感染的诊断被延迟,这表明尤其需要在临床医生的普及教育和准确的病毒检测方面做出更多努力。