Azimi Shohreh, Sabokbar Azar, Bairami Amir, Gharavi Mohammad Javad
Department of Microbiology, Karaj Branch, Islamic Azad University, Karaj, Iran.
Department of Medical Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
Iran J Parasitol. 2019 Apr-Jun;14(2):280-287.
pneumonia (PCP) remains a leading cause of mortality among HIV-infected patients. The aim of study was to find out in versatile group of HIV-positive patients prisoners.
Overall, 102 HIV positive patients from Ghezel Hesar Prison, Karaj, Iran from October 2016 to March 2017 without any respiratory symptoms were selected with different medication histories against HIV and PCP. Microscopic and molecular (qualitative real-time PCR) examination were applied on sputum specimens and serological investigation (β-D-glucan assay for fungal diseases) carried out on patient's sera.
Only 3 and 1 patients were positive for PCP by microscopic and molecular testing, respectively. Twenty-four (23.5%) and 78 (76.5%) out of 102 patients were seropositive and seronegative for fungi disease, respectively. Seropositive patients were older than seronegative subjects (<0.001). Most of seropositive individuals showed less mean value of CD4 counts compared to seronegative group (<0.001). Of 54 patients who were under HIV therapy, 13 were seropositive compared to 11 out of 24 seropositives who were no adhere to treatment (<0.001). In terms of prophylactic antibiotic therapy against PCP, of 24 patients who received prophylaxis, 3 (12.5%) and 21 (87.5%) were seropositive and seronegative, respectively (<0.001). On the contrary, among 78 patients who did not receive prophylaxis, 21 (27%) and 57 (73%) belonged to seropositive and seronegative patients, respectively (<0.001).
There was no strong evidence for PCP infection/disease among symptomless, HIV positive patients. According to their mean CD4 counts, the hypothesis for being negative in a majority of applied tests would be the absence of severe immunosuppression in the patients.
肺炎（肺孢子菌肺炎，PCP）仍是HIV感染患者死亡的主要原因。本研究的目的是在一群多样化的HIV阳性囚犯患者中进行调查。
2016年10月至2017年3月期间，从伊朗卡拉季的盖泽尔黑萨尔监狱选取了102名无任何呼吸道症状的HIV阳性患者，这些患者有不同的抗HIV和PCP用药史。对痰液标本进行显微镜检查和分子检测（定性实时PCR），并对患者血清进行血清学调查（用于真菌疾病的β-D-葡聚糖检测）。
通过显微镜检查和分子检测，分别仅有3例和1例PCP呈阳性。102例患者中，24例（23.5%）真菌疾病血清学检测呈阳性，78例（76.5%）呈阴性。血清学阳性患者比血清学阴性患者年龄大（<0.001）。与血清学阴性组相比，大多数血清学阳性个体的CD4细胞计数平均值较低（<0.001）。在接受HIV治疗的54例患者中，13例血清学呈阳性，而在24例未坚持治疗的血清学阳性患者中有11例（<0.001）。在针对PCP的预防性抗生素治疗方面，在接受预防治疗的24例患者中，3例（12.5%）血清学呈阳性，21例（87.5%）呈阴性（<0.001）。相反，在未接受预防治疗的78例患者中，21例（27%）为血清学阳性患者，57例（73%）为血清学阴性患者（<0.001）。
在无症状的HIV阳性患者中，没有强有力的证据表明存在PCP感染/疾病。根据他们的平均CD4细胞计数，大多数应用检测呈阴性的假设原因可能是患者不存在严重免疫抑制。
