A Retrospective Study Of AIDS Patients Of Opportunistic Infection In Henan Province Between 2009 And 2013

Objective:To investigate disease category and the incidence on opportunistic infection of AIDS patients in Henan Province from 2009 to 2013, Sum up characteristics and rules of opportunistic infections in AIDS patients in the era of highly active antiretroviral therapy, to provide scientific basis for prevention and control of the HIV/AIDS.Methods:Data of inpatient AIDS patients with opportunistic infections were retrospectively analyzed from Jan.of 2009 to Dec.of 2013 in Henan Infectious Disease Hospital. The study was carried out by using Excell form, including the content such as gender, age, infection route, treatment time, the date of complication, prognosis and CD4+T lymphocyte counts when the patient with complications.Result:Of 1314 HIV/AIDS patients, the average age was 42.47±12.5 years.456 Patients without receiving antiviral therapy of AIDS as non-antiviral therapy group,858 cases with antiviral therapy as treated group. In therapy group, the rate of male and female was1.28:1,while was 2.26:1 in non therapy group. Most of the patients with therapy belonged to the age groups:41-60(56.88%),but it ocuppy 49.34% in non-therapy patient.The infection pathway in therapy group were mainly blood collection and supply (38.69%) and transfusion (27.04%). In non-therapy, through homosexual was 29.61%,blood collection and supply was 25.88%. Farmers and peasant workers constitute the majority of the two groups,most of patients come from Zhumadian, Zhoukou and Nanyang in South Henan Province.The 1314 AIDS patients experienced 2645 cases of HIV-related opportunistic infections,involving respitatory(47%),gastrointestinal(20%) and central nervous (10%) systems. The most common opportunistic infections were:bacterial pneumonia (24.31%), oral candidiasis(12.78%),pulmonary tuberculosis(9.26%),pneumocystis jiroveci pneumonia(7.71%),infective diarrhea(4.69%),Cytomegalovirus pneumonia (4.01%) and lymph node tuberculosis(3.97%).266 strains pathogens were isolated.Bacteria ranked first, accounting for 53.38%, fungi ranked second,28.95%%. Pathogens mainly comefrom the lower respiratory tract,Secondly from Cerebrospinal Fluid.Among the Bacteria, the main pathogens included Escherichia Coli,Klebsiella pneumonia Pseudomonas. Most of fungi is Cryptococcus.Bacterial pneumonia,oral candidiasis,pneumocystis jiroveci pneumonia, cytomegalovirus pneumoniaand, fungal pneumonia,cryptococcal meningitis had the lower incidence rate in the non-antiviral therapy group. The incidences of tuberculous pleurisy was found no significant difference between the two groups (P=0.163). The median value of CD4+ T cell count of HIV-related opportunistic infections in antiviral therapy group had higher than the non-therapy group.Patients with one kind of HIV-related opportunistic infection in antiviral therapy group is most cases(40.32%), the median value of CD4+T cell count of cases is 304/μl.In the non-therapy group,Patients with two or three kind of opportunistic infection is most(49.67%), the median value of CD4+T cell count of cases below 100/μlThere were 70 cases progressive disease and death,of 49 is male,of 13 is female.Death patients had received antiviral therapy before death,account for 31.43%.The cause of death of 62 patients (88.57%) were due to HIV-related opportunistic infection.Conclusion:HIV-related opportunistic infections are easily encountered in digestive and respiratory systems in the era of highly active antiretroviral therapy.The spectra of opportunistic infections were changed,the incidence rate of serious, fatal and multiple opportunistic infections after therapy.Most of Pathogens of opportunistic infection were Bacteria and fungi. The low positive rate of aetiology becomes a difficult problem about diagnosis and treatment of infection. It is shown that a close correlation exists between CD4+T cell count and number,incidence kinds of opportunistic infection. Different cause of infections were found, different measures should been taken after antiretroviral therapy. The incidence rate of infections is still higher after antiretroviral treatment,then infection still is reasons of visiting hospital and hospitalization,even just cause of death. So it is the first task for improve HIV/AIDS patients immunity and reduce infection rate.