Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
J Acquir Immune Defic Syndr. 2018 Oct 1;79(2):158-163. doi: 10.1097/QAI.0000000000001802.
Diffuse infiltrative lymphocytosis syndrome (DILS) is the term used for sicca syndrome in HIV patients and has similar clinical manifestations as Sjögren syndrome. In this nationwide population-based study, we aimed to determine the association between HIV infection and DILS in the Taiwanese population.
The National Health Insurance Research Database was searched for cases of DILS in HIV-infected individuals diagnosed between January 1, 2000, and December 31, 2012. The incidence of DILS and the factors associated with DILS in people living with HIV/AIDS (PLWHA) were determined.
A total of 20,364 PLWHA were followed, and 57 (0.28%) individuals had new-onset DILS. The incidence rate of DILS in PLWHA was 0.56/1000 person-years. One (0.11%) female HIV patient with highly active antiretroviral therapy (HAART) and 24 (2.99%) without HAART had incident DILS, whereas 22 (0.17%) male HIV patients with HAART and 10 (0.17%) without HAART had incident DILS. Hypertension increased the risk of incident DILS. HAART decreased the risk of DILS, but this relationship somewhat attenuated in an adjusted model. None of the patients taking emtricitabine, raltegravir, darunavir, enfuvirtide, or tipranavir developed DILS. Lopinavir was associated with a decreased risk of DILS (adjusted hazard ratio = 0.10, 95% confidence interval: 0.01 to 0.84), whereas zalcitabine was associated with an increased risk of DILS (adjusted hazard ratio = 13.7, 95% confidence interval: 2.18 to 85.9).
DILS is a rare disease found in PLWHA. Hypertension is a risk factor for incident DILS, and HAART could affect the pathogenesis of DILS. Zalcitabine was the only antiretroviral agent found to increase the risk of DILS.
弥漫性浸润性淋巴细胞增多症（DILS）是用于描述 HIV 患者干燥综合征的术语，其临床表现与干燥综合征相似。在这项全国性的基于人群的研究中，我们旨在确定 HIV 感染与台湾人群中 DILS 之间的关联。
检索了 2000 年 1 月 1 日至 2012 年 12 月 31 日期间确诊为 HIV 感染的个体中 DILS 的病例。确定了 HIV 感染者中 DILS 的发生率以及与 HIV 感染者相关的 DILS 相关因素。
共对 20364 名 HIV 感染者进行了随访，其中 57 名（0.28%）患者出现新发 DILS。HIV 感染者中 DILS 的发病率为 0.56/1000 人年。1 名（0.11%）接受高效抗逆转录病毒治疗（HAART）的女性 HIV 患者和 24 名（2.99%）未接受 HAART 的患者发生了 DILS，而 22 名（0.17%）接受 HAART 的男性 HIV 患者和 10 名（0.17%）未接受 HAART 的患者发生了 DILS。高血压增加了 DILS 发病的风险。HAART 降低了 DILS 的风险，但在调整模型中，这种关系有所减弱。未发现服用恩曲他滨、拉替拉韦、达芦那韦、恩夫韦肽或替诺福韦的患者发生 DILS。洛匹那韦与 DILS 的发病风险降低相关（调整后的危险比=0.10，95%置信区间：0.01 至 0.84），而扎西他滨与 DILS 的发病风险增加相关（调整后的危险比=13.7，95%置信区间：2.18 至 85.9）。
DILS 是 HIV 感染者中罕见的疾病。高血压是 DILS 发病的危险因素，而 HAART 可能影响 DILS 的发病机制。扎西他滨是唯一发现会增加 DILS 发病风险的抗逆转录病毒药物。
