Department of West China School of Public Health, No.4 West China Teaching Hospital, Sichuan University.
Department of Laboratory, Public Health Clinical Center of Chengdu.
Tohoku J Exp Med. 2018 Mar;244(3):231-242. doi: 10.1620/tjem.244.231.
Opportunistic infections (OIs) are the most significant complication of human immunodeficiency virus (HIV) infection. The prevalence of OIs differs among various countries in part due to different climates and socio-economic conditions. We, therefore, carried out the retrospective study at the Public Health Clinical Center of Chengdu, Sichuan to comprehensively investigate the prevalence of OIs, predictors of OIs, and risk factors for in-hospital death among HIV-infected patients. Sichuan in West China is characterized by the largest population living with HIV/Acquired immunodeficiency syndrome (AIDS) across China. In total, we reviewed 954 cases of HIV infection, admitted to the hospital during January 2014 to December 2015, and found that bacterial pneumonia (25.8%) was the most common OIs, followed by candida infection (18.3%), Pneumocystis jiroveci pneumonia (11.9%), tuberculosis (11.5%), infectious diarrhoea (9.3%), cryptococcus infection (7.3%), cytomegalovirus infection (4.9%), toxoplasmosis (4.6%), hepatitis C (4.0%), nontuberculous mycobacteria desease (2.2%) and Penicillium marneffei infection (0.3%). We also found two strongest risk factors for in-hospital mortality: CD4+T cell counts of less than 100 cells/μL and not receiving antiretroviral therapy. Moreover, the study revealed the specific pathogens causing bacterial pneumonia and/or candida infection, the effect of tuberculosis on CD4+T cell counts, and the drug resistance of Mycobacterium tuberculosis among HIV-infected and non-HIV-infected patients. The present findings may aid in the clinical diagnosis and treatment of HIV-infected patients, and could help developing efficient public health strategies in China.
机会性感染(OIs)是人类免疫缺陷病毒(HIV)感染最严重的并发症。由于气候和社会经济条件的不同,不同国家的 OI 患病率存在差异。因此,我们在四川成都公共卫生临床医疗中心进行了回顾性研究,旨在全面调查 HIV 感染患者 OIs 的患病率、OIs 的预测因素以及住院死亡的危险因素。中国西部的四川是全国 HIV/AIDS 患者数量最多的省份。我们共回顾了 2014 年 1 月至 2015 年 12 月期间因 HIV 感染住院的 954 例病例,发现细菌性肺炎(25.8%)是最常见的 OIs,其次是念珠菌感染(18.3%)、肺孢子菌肺炎(11.9%)、结核病(11.5%)、感染性腹泻(9.3%)、隐球菌感染(7.3%)、巨细胞病毒感染(4.9%)、弓形虫病(4.6%)、丙型肝炎(4.0%)、非结核分枝杆菌病(2.2%)和马尔尼菲青霉菌感染(0.3%)。我们还发现了两个导致住院死亡的最强危险因素:CD4+T 细胞计数<100 个/μL 和未接受抗逆转录病毒治疗。此外,该研究还揭示了导致细菌性肺炎和/或念珠菌感染的特定病原体、结核病对 CD4+T 细胞计数的影响以及 HIV 感染和非 HIV 感染患者中结核分枝杆菌的耐药性。本研究结果可能有助于 HIV 感染患者的临床诊断和治疗,并有助于在中国制定有效的公共卫生策略。