In recent years, the incidence rate of ischemic stroke in people living with HIV/AIDS (PLWHA) is increasing, attracting wide attention from scholars at home and abroad. In addition to traditional risk factors of stroke, the secondary ischemic stroke in PLWHA is also affected by HIV infection. This study reviews the incidence rate and risk factors of secondary ischemic stroke in PLWHA, in order to provide a theoretical basis for preventing and reducing the incidence of ischemic stroke in PLWHA.
Human immunodeficiency virus (HIV)-1 p24 antigen is one of the earliest proteins appearing after HIV infection. It can be used as a diagnostic marker to shorten the detection “window period” to about 14 days. It is of vital importance in the process of early diagnosis and antiviral therapy monitoring. This review briefly describes the basic structure and clinical significance of detection of HIV-1 p24 antigen, focusing on the current domestic and foreign researches on the biosensors of HIV-1 p24 antigen based on new nanomaterials, in order to provide a reference for developing novel detection technology.
【摘要】 目的 观察人类免疫缺陷病毒（HIV）感染后对人体各个系统的影响，为其诊断和治疗提供经验。 方法 回顾性分析2005年1月—2010年6月于华西医院确诊为HIV感染13例患者的临床表现和相关实验室指标。 结果 13例HIV感染患者均合并其他感染，以结核病最为常见；除有T淋巴细胞异常外，多数患者可合并出现血液学异常，包括贫血、白细胞和血小板降低；生化异常，包括球蛋白升高、白蛋白降低；HIV感染患者可合并出现风湿病症状和免疫学异常。 结论 HIV感染患者临床表现复杂多样，可合并出现多种感染和风湿病症状，血液学及免疫学异常也比较常见。【Abstract】 Objective To observe the impact of human immunodeficiency virus (HIV) on each system of human body after its infection, in order to provide experiences for diagnosis and treatment of this disease. Methods The clinical manifestations and related laboratory results of 13 inpatients treated in West China Hospital of Sichuan University from January 2005 to June 2010 were reviewed retrospectively. Results The incidence of infection in these patients was 100% with tuberculosis as the most common infection. Apart from the abnormality of T lymphocytes, most patients had a change of hematology and biochemistry, including anemia, depression of leucocytes and platelets, hyperglobulinemia and hypoproteinemia; HIV-infected patients may also presented with rheumatic manifestations or abnormality in the immune system. Conclusion The clinical manifestations of patients with AIDS are complicated. Many kinds of infections and rheumatic manifestations may merge and the change in hematology and immunology is common.
Objective To analyze the clinical epidemiological characteristics and trends of newly reported human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Panzhihua Central Hospital, and provide a scientific basis for general hospitals to formulate precise prevention and control measures. Methods The information such as gender, age, ethnicity, and transmission route of the newly reported HIV/AIDS patients in Panzhihua Central Hospital from 2010 to 2019 was retrospectively analyzed. Results A total of 551545 patients were screened for HIV in Panzhihua Central Hospital between 2010 and 2019, among them, 1091 patients were confirmed as HIV infection finally, with a confirmed positive rate of 0.20%. The number of confirmed cases and the positive rate continued to increase from 2010 to 2017, and obviously declined after 2018. The male to female ratio of newly diagnosed HIV/AIDS patients was 2.86∶1, and the 31-45 years old middle-aged and young adults were the majority (31.16%). The majority of HIV/AIDS patients were identified as married (58.02%), primary school education (40.70%), farmers (46.38%), and Han nationality (79.84%). Yi nationality also had a high proportion (18.52%) with an increasing trend year by year (χ2trend=8.131, P=0.004). Yi nationality patients were mainly from Liangshan Yi Autonomous Prefecture (58.42%). A high proportion of 50.32% of patients came from other cities, among them, the proportion of patients from Liangshan Yi Autonomous Prefecture increased over time (χ2trend=13.608, P<0.001). The transmission routes were mainly through heterosexual sex (90.93%), with an upward tendency of proportion (χ2trend=22.137, P<0.001), and transmission through drug abuse was following (4.49%), with an downward tendency of the proportion (χ2trend=11.758, P=0.001). Significant differences in transmission routes were observed between males and females (P=0.020), and between Han nationality and Yi nationality (P<0.001). Conclusion The newly repored HIV/AIDS patients in Panzhihua Central Hospital have a high proportion of minority nationality, and heterosexual transmission is the main transmission route.
Objective To analyze the clinical data of monkeypox (mpox) cases in Chengdu, to investigate the clinical characteristics of patients with mpox complicated with human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS), and provide reference for clinical diagnosis and treatment. Methods Mpox patients admitted to Public Health Clinical Center of Chengdu between June 29 and August 8, 2023 were continuously included. Patients were divided into an observation group and a control group based on whether they were complicated with HIV/AIDS. The clinical characteristics of two groups of patients were observed and compared. Results A total of 56 patients were included, all of whom were male; Age range from 19 to 51 years old, with an average of (31.6±5.9) years old; There were 23 cases in the observation group and 33 cases in the control group. Except for age, perianal lesions with infection, number of rashes, diarrhea, CD4+ lymphocyte count, CD4/CD8 ratio, syphilis, chest CT abnormalities, rash duration, and length of hospital stay (P<0.05), there was no statistically significant difference in epidemiological data, clinical features, auxiliary examinations, treatment, and intensive care unit admission between the two groups of patients (P>0.05). There was a statistically significant difference between the Ct values of throat swab nucleic acid and blister fluid nucleic acid in the total population [(30.1±4.4) vs. (23.4±3.8); t=5.462, P<0.001]. Conclusions Mpox patients complicated with HIV/AIDS are prone to persistent, diverse, and severe lesions due to relatively lower CD4+ lymphocyte counts. Therefore, it is necessary to actively provide symptomatic treatment and prevent complications for patients.
Objective To evaluate the relation of human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) loads in cerebrospinal fluid with central neurological diseases. Methods The inpatients with HIV-1 infection diagnosed by Public Health Clinical Center of Chengdu between January 1st, 2015 and March 1st, 2018 were retrospectively included. The included patients were divided into central neurological disease group and non-central neurological disease group, and high viral load group and low viral load group. The demographic data, CD4+ T lymphocyte count, routine detection of cerebrospinal fluid, HIV RNA load in cerebrospinal fluid and plasma of patients with and without central neurological diseases were observed and compared.Multiple logistic regression analysis was used to identify risk factors for central neurological diseases. Results A total of 367 patients were included. In the central neurological disease group, 210 cases (57.22%) were complicated with central neurological diseases, and cryptococcus infection was the most. Compared with the non-central neurological disease group, the increase rate of cerebrospinal fluid cell counts, cerebrospinal fluid cell counts, cerebrospinal fluid HIV RNA positivity and cerebrospinal fluid HIV RNA load were higher in the central neurological disease group (P<0.05). Logistic regression analysis showed that HIV RNA load in cerebrospinal fluid≥100 000 copies/mL and CD4+ T lymphocyte count<200 cells/mm3 were risk factors for central neurological diseases. Conclusion Cerebrospinal fluid HIV RNA load≥100 000 copies/mL is an independent risk factor for HIV/AIDS patients with central neurological diseases and clinical treatment should take this factor into consideration to reasonably optimize the selection of antiretroviral therapy.
ObjectiveTo evaluate the clinical significance of human immunodeficiency virus (HIV) testing algorithm combining antigen/antibody assay screening with Western Blot (WB) or HIV nucleic acid.MethodsData of HIV antigen and antibody screening samples in West China Hospital of Sichuan University in 2018 were retrospectively analyzed. The 4th generation antigen and antibody reagents were used for initial screening, and the 3rd generation antibody reagents were used for reexamination. WB or HIV nucleic acid detection was performed as supplementary test.ResultsA total of 217 803 samples were initially screened, 718 samples were positive in initial screening (0.33%) and 513 samples were confirmed positive (0.24%). The 718 initial positive samples were confirmed by WB, among them, 513 (71.45%) were positive, 163 (22.70%) were negative, and 42 (5.85%) were indeterminate. Fifteen samples which were negative or indeterminate were detected by HIV RNA, as a result, 6 were positive. Two of four patients turned into positive during follow-up. Among the 536 samples which were positive in both the 4th and 3rd generation assay, there were 513 (95.71%) positive, 6 (1.12%) negative, and 17 (3.17%) indeterminate confirmed by WB; among the 182 samples which were positive in the 4th generation assay but negative in the 3rd generation assay, there were none (0.00%) positive, 157 (86.26%) negative, and 25 (13.74%) indeterminate confirmed by WB. The positive rate of confirmation test of samples positive in the 4th and 3rd generation assay (95.71%, 513/536) was significantly higher than that of samples positive in the 4th generation assay but negative in the 3rd generation assay (0%, 0/182), and the difference was statistically significant (χ2=610.091, P<0.001). WB band types for positive samples were dominated by the whole bands and sub-bands, accounting for 82.26%. The cut off index in ≥5 bands group was higher than that in < 4 bands group (P<0.001).ConclusionsSamples with both the 4th and 3rd generation assay positive have a high positive rate of confirmation test, and a supplementary test is needed to be done as soon as possible to confirm the diagnosis. Samples with only the 4th generation assay positive have a low positive rate of confirmation test. But for patients with a high-risk history, HIV nucleic acid should be done as soon as possible for early diagnosis.
ObjectiveTo compare the value of CURB-65 score and expanded CURB-65 score in evaluating prognosis of pneumonia in non-HIV infected patient and HIV infected patient.MethodsThe study included 206 hospitalized pneumonia patients without HIV infection and 299 pneumonia patients with HIV infection. According to their clinical prognosis within 4 weeks of treatment, they were divided into a deterioration group and an improvement group. The basic situation and the differences of clinical indicators between the two groups were compared. The predictive value of CURB-65 score and expanded CURB-65 score for clinical prognosis of pneumonia in non-HIV infected patients and HIV infected patients was compared by using receiver operator characteristic (ROC) curve.ResultsFor the pneumonia patients without HIV infection, the area under ROC curve (AUC) of CURB-65 score and expanded CURB-65 score were 0.862 and 0.848, respectively. There was no significant difference in AUC between CURB-65 score and expanded CURB-65 score (Z=0.661, P=0.5084). The Youden indexes of CURB-65 score and expanded CURB-65 score were 60.11% and 54.92%, respectively. For the pneumonia patients with HIV infection, the AUC of CURB-65 score and expanded CURB-65 score were 0.588 and 0.634, respectively. There was no significant difference between them (Z=1.416, P=0.1567). The Youden index of the two scores was 19.53% and 20.52%, respectively.ConclusionsThe CURB-65 score and expanded CURB-65 score can effectively evaluate the clinical prognosis of pneumonia in non-HIV infected patients, but their predicted values are limited in evaluating the prognosis of pneumonia in HIV infected patients.