台湾某市立医院HIV/AIDS的临床经验。

Y L Wu, C C Chang, H C Chang, C H Yang, S T Liao
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摘要

摘要为了描述市立医院感染人类免疫缺陷病毒1型(HIV-1)患者的流行病学特征和主要临床表现,我们对1990年1月至1996年7月间在台北市仁爱医院收治的53例HIV-1感染患者进行了回顾性分析。该队列中大多数患者(94.3%)为男性。发病率高峰出现在第四个十年(28.3%)。44例(83%)患者首次住院时出现获得性免疫缺陷综合征(AIDS)。从诊断为HIV-1感染到诊断为艾滋病的平均时间为11.2(0 ~ 84)个月。在研究组中,异性恋传播占感染的54.7%,双性恋/同性恋男性占32%。2例患者出现新发精神病。在所有艾滋病指标条件下,卡氏肺囊虫肺炎(PCP)是艾滋病患者中主要的机会性感染。PCP在HIV-1感染的初始表现中也居首位。一名感染马尔尼菲青霉的患者被诊断为艾滋病。艾滋病患者入院时平均CD4计数明显低于非艾滋病患者(32 vs 297/微升,p < 0.0005)。在随访期间,53例患者中有24例死亡。23例确诊后死亡患者的平均生存时间为6.4(0 ~ 29)个月。结果表明,男性病例数大大超过女性。性行为仍然是最重要的感染途径。新发精神病可能是hiv相关脑病的早期表现,需要更多的关注。此外,结果也很差,因为该地区的大多数患者直到艾滋病严重发展到需要寻求医疗帮助时才意识到感染艾滋病毒-1的风险。PCP是最常见的医疗咨询动机。马尔尼菲青霉感染是东南亚地区的一种地方病,在台湾应被列为艾滋病的指示性疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical experience of HIV/AIDS in a municipal hospital in Taiwan.

To describe the spectrum of epidemiological and major clinical manifestations of patients infected by human immunodeficiency virus type 1 (HIV-1) in a municipal hospital, a retrospective review was done of 53 HIV-1-infected patients who had been admitted to Taipei Municipal Jen-Ai Hospital between January 1990, and July 1996. The majority (94.3%) of the patients in the cohort were male. Peak incidence was found in the fourth decade (28.3%). Forty-four (83%) patients presented in the first hospital stay with acquired immunodeficiency syndrome (AIDS). The mean duration between establishment of diagnosis of HIV-1 infection and that of AIDS was 11.2 (0-84) months. Heterosexual transmission accounted for 54.7% of the infections in the study group, and bi-/homosexual men made up another 32%. Psychosis of new onset was noted in two patients. In all AIDS indicator conditions, Pneumocystis carinii pneumonia (PCP) was the leading opportunistic infection among AIDS patients. PCP was also on the top of initial manifestations of HIV-1 infection. One patient with Penicillium marneffei infection was diagnosed to have AIDS. The mean CD4 count at admission of AIDS patients was much lower than that of non-AIDS patients (32 vs. 297/microliter, p < 0.0005). During the follow-up period 24 of 53 patients died. Mean survival time of 23 expired patients after establishment of diagnosis of AIDS was 6.4 (0-29) months. The results indicated that males outnumbered females greatly in the number of cases. Sexual activity remained the most important route of infection. Psychosis of new onset may be an early manifestation of HIV-associated encephalopathy and requires more attention. In addition, the outcome was poor as most patients in this area did not become aware of risk of HIV-1 infection until they were seriously illed with full-blown AIDS that they would seek medical help. PCP was the most common incentive for medical consultation. Penicillium marneffei infection is endemic in southeast Asia, and should be classified as an AIDS indicator condition in Taiwan.

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