Chen Jun, Zhang Renfang, Shen Yinzhong, Liu Li, Qi Tangkai, Wang Zhenyan, Song Wei, Tang Yang, Lu Hongzhou
Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Am J Trop Med Hyg. 2017 Jun;96(6):1350-1354. doi: 10.4269/ajtmh.16-0521.
Abstract infection is increasingly observed in people living with human immunodeficiency virus (HIV) in eastern China, a nonendemic area. This study aimed to draw the clinician's attention to this disease by presenting the clinical characteristics and prognosis of penicilliosis among HIV-infected patients from this region. We retrospectively analyzed HIV-infected patients with culture-proven infection admitted during January 1, 2014-December 31, 2015, at the Shanghai Public Health Clinical Center. A total of 48 patients with confirmed HIV infection and penicilliosis were enrolled, which accounted for a mean of 3.2% (95% confidence interval: 2.4-4.2%) of yearly HIV infection admissions among patients from eastern China. Symptoms included fever, cough, and gastrointestinal complaints, whereas the most common sign was skin lesions. Anemia occurred in 87.5% (42/48) of the patients. The overall mortality rate was 16.7%. Low CD4 T-cell count and hemoglobin level were correlated with mortality. Based on these results, we concluded that penicilliosis should be considered in HIV-infected patients from eastern China who present with fever, cutaneous lesions, and anemia. The clinical characters and the prognosis of patients with penicilliosis are similar to those in endemic areas. More attention should be paid to penicilliosis patients with low CD4 T-cell count and/or low hemoglobin level.
摘要 在非艾滋病流行区的中国东部,人类免疫缺陷病毒(HIV)感染者中侵袭性肺曲霉病的发病率日益增加。本研究旨在通过呈现该地区HIV感染患者侵袭性肺曲霉病的临床特征及预后,引起临床医生对该病的关注。我们回顾性分析了2014年1月1日至2015年12月31日期间在上海公共卫生临床中心收治的经培养证实患有侵袭性肺曲霉病的HIV感染患者。共有48例确诊为HIV感染并患有侵袭性肺曲霉病的患者入组,占中国东部地区每年HIV感染住院患者的3.2%(95%置信区间:2.4-4.2%)。症状包括发热、咳嗽和胃肠道不适,而最常见的体征是皮肤病变。87.5%(42/48)的患者出现贫血。总死亡率为16.7%。低CD4 T细胞计数和血红蛋白水平与死亡率相关。基于这些结果,我们得出结论,对于来自中国东部出现发热、皮肤病变和贫血的HIV感染患者,应考虑侵袭性肺曲霉病。侵袭性肺曲霉病患者的临床特征和预后与流行地区的患者相似。应更加关注CD4 T细胞计数低和/或血红蛋白水平低的侵袭性肺曲霉病患者。