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目的了解上海地区艾滋病患者的基本信息以及抗反转录病毒治疗(ART)前各种机会感染的发生概率,为早发现艾滋病病毒(HIV)感染者提供参考。方法 ART前收集初治艾滋病患者年龄、婚姻状况、配偶是否感染、确诊日期、既往是否接受过ART、体重等基本信息,以及确诊机会感染和机会肿瘤、曾出现的免疫低下的临床表现以及现患机会感染和机会肿瘤等,并进行统计分析。结果 1 153例初治艾滋病患者中男性955例,女性198例,开始ART时平均年龄(39.7±12.5)岁。自述配偶也为感染者的共124例,其中45对为夫妻均在接受ART。1 153例患者平均CD4+细胞计数为(139.7±109.0)个/μl。共计1 238例次发生AIDS相关性疾病或临床表现,以消瘦最为常见358例次(31.05%),其次为持续发热252例次(21.86%)、带状疱疹208例(18.04%)。457例因各种机会感染或肿瘤住院治疗并开始ART,CD4+细胞计数为(77.8±94.3)个/μl,发生AIDS相关性疾病为1 133例次(91.52%)。696例在门诊开始ART的患者,CD4+细胞计数为(180.9±98.0)个/μl,发生过AIDS相关性疾病的例次仅为105(8.48%)。结论相当一部分患者在确诊前已经出现了免疫功能低下的表现。AIDS晚期患者(尤其是CD4+细胞计数<100个/μl)在开始ART前更可能发生各种较严重的多重机会性感染。
Objective To understand the basic information of AIDS patients in Shanghai and the incidence of various opportunistic infections before antiretroviral therapy (ART), so as to provide a reference for early detection of HIV infection. Methods Before ART, the age, marital status, spouse’s infection, date of diagnosis, prior information such as ART and weight, and the diagnosis of opportunistic infections and opportunistic neoplasms, the clinical manifestations of immunodeficiency and the prevalence of pre-existing AIDS were collected. Opportunistic infections and opportunistic tumors, etc., and statistical analysis. Results A total of 1 153 cases of newly diagnosed AIDS patients were 955 males and 198 females, with an average age of (39.7 ± 12.5) years at the start of ART. A total of 124 self-reported spouses are also infected, of which 45 couples are receiving ART. The mean CD4 + cell count in 1 153 patients was (139.7 ± 109.0) / μl. A total of 1 238 cases of AIDS-related diseases or clinical manifestations to weight loss the most common 358 cases (31.05%), followed by 252 cases of persistent fever (21.86%), 208 cases (18.04%) of herpes zoster. 457 cases were hospitalized with various opportunistic infections or tumors and started ART. The CD4 + cell count was (77.8 ± 94.3) / μl, and the number of AIDS-related diseases was 1 133 cases (91.52%). Among the 696 patients who started ART at the outpatient setting, CD4 + cell count was (180.9 ± 98.0) / μl, with only 105 (8.48%) cases of AIDS-related disease occurring. Conclusions A significant proportion of patients have had immunocompromised prior to diagnosis. Patients with advanced AIDS (especially CD4 + cell counts <100 / μl) are more likely to develop various more severe multiple opportunistic infections before starting ART.