Spectrums of Opportunistic Infections and Malignancies in HIV-Infected Patients in Tertiary Care Hospital, China

Abstract

BackgroundHIV-related opportunistic infections (OIs) and malignancies continued to cause morbidity and mortality in Chinese HIV-infected individuals. The objective for this study is to elucidate the prevalence and spectrums of OIs and malignancies in HIV-infected patients in the Beijing Ditan Hospital.MethodsThe evaluation of the prevalence and spectrums of OIs and malignancies was conducted by using the clinical data of 834 HIV-infected patients admitted in the Beijing Ditan hospital from January 1, 2009, to November 30, 2012.ResultsThe prevalence and spectrums of OIs and malignancies varied contingent on geographic region, transmission routes, and CD4 levels. We found that tuberculosis was most common OI and prevalence was 32.5%, followed by candidiasis(29.3%), Pneumocystis pneumonia(PCP)(22.4%), cytomegalovirus(CMV) infection(21.7%), other fungal infections(16.2%), mycobacterium avium complex(MAC)(11.3%), cryptococcosis(8.0%), progressive multifocal leukoencephalopathy(PML)(4.4%), Cerebral Toxoplasmosis(3.5%) and Penicillium marneffei infection(1.4%); while Lymphoma(2.9%), Kaposi’s sarcoma(0.8%) and cervix carcinoma(0.3%) were emerged as common AIDS-defining malignancies. Pulmonary OI infections were the most prevalent morbidity and mortality in patients in the AIDS stage including pulmonary tuberculosis (26.6%) and PCP (22.4%). CMV infection(21.7%) was most common viral infection; Fungal OIs were one of most prevalent morbidity in patients in the AIDS stage, including oral candidiasis (29.3%), other fungal infection (16.2%), Cryptococcosis (8.0%) and Penicillium marneffei infection (1.4%). We found the low prevalence of AIDS-defining illnesses in central neural system in this study, including progressive multifocal leukoencephalopathy (4.4%), cerebral toxoplasmosis (3.5%), tuberculosis meningitis (3.2%), cryptococcal meningitis (2.4%) and CMV encephalitis (1.1%). In-hospital mortality rate was 4.3 per 100 person-years due to severe OIs, malignancies, and medical cost constraints.ConclusionsThe prevalence and spectrums of OIs, malignancies and co-infections were discussed in this study. It would help increase the awareness for physicians to make a diagnosis and empirical treatment sooner and plan good management strategies, especially in resource limited regions.

Etiology and outcomes for patients infected with HIV in intensive care units in a tertiary care hospital in China

“…In this study, respiratory failure (53.4%), pneumothorax (12.4%) and infectious shock (8.5%) were the three most common causes of admission to intensive care units. The results revealed that 74.3% of patients infected with HIV were admitted to intensive care units because of severe pulmonary opportunistic infections in this cohort, and this reflects the clinical characteristics of Chinese HIV‐infected patients; that is, patients infected with HIV are not aware of HIV infection until opportunistic infections became the first indicator of their disease [Xiao et al, ]. Shrosbree et al [Shrosbree et al, ] reported that late HIV diagnosis was a major risk factor for admission to intensive care units in patients infected with HIV in South‐East England.…”

Serum TRSUT Titer ≥1

“…After all, there are so many kinds of central nervous system infections among HIV-infected patients such as bacterial meningitis, tuberculous meningitis, and cryptococcal meningitis. 19,20 So the real challenge is to decide whether or when to perform the lumbar puncture among HIV/syphilis-infected patients without neurological symptoms.…”

Anemia in combined antiretroviral treatment-naive HIV-infected patients in China: A retrospective study of prevalence, risk factors, and mortality

“…Despite the availability of cART in China (15), confirmatory anti-HIV antibody testing is often performed late, once HIV infection has progressed to AIDS and CD4 counts are low, as many people are unaware of HIV infection (16). Both clinically advanced disease and low CD4 counts are associated with an increased risk of anemia (17).…”