The Clinical And Lung Imaging Analysis Of HIV/AIDS Co-Infection With TB And/OR PSM

Objectives To analysis the clinical and imaging of the patients HIV/AIDS co-infected with tuberculosis(TB) and Penicilliosis Marneffei (PSM),explore the opportunistic of AIDS related factors, which will provide the basis for the patients with persistent antiviral treatment.Methods 972 cases of HIV diagnosed at the Department of infectious diseases, the Fourth People’s Hospital of Nanning, the Guangxi Zhuang Autonomous Region from January 2015 to December 2015 were retrospectively analyzed, and the clinical characteristics and imaging examinations of the diseases were comparative analysis. Among them,112 cases complicated with TB,59 cases complicated with PM,93 cases complicated with pulmonary TB and PM.Results (1)The ages of 264 cases of HIV/TB、PM from 11-78 years old, The average age of them was 48.95 years old, It Mainly in the middle and young adults (30-59 years old, accounting for 68.80%), the incidence of adolescent and elderly, and the 204 cases were Male(accounting for 77.27%), 60 cases were female(accounting for 22.73%).(2) The common symptoms of HIV/TB patients are fever, cough, sputum, anaemic, angular, respectively accounted for 54.46%,66.96%,63.39%,66.96% and 27.68%. The common symptoms of HIV/PM are fever, fatigue, weight, skin lesions, accounted for 57.63%,47.46%,42.37% and 57.63% The common symptoms of HIV/TB/PM are fever, cough, sputum, angular, skin lesions, respectively 60.22%,62.37%, 55.91%,32.26%,55.91%.HIV/PM patients with symptoms of cough, sputum less than HIV/TB and HIV/TB/PM patients (P< 0.001);HIV/TB skin damage, liver and spleen enlargement, significantly less than HIV/PM and HIV/TB/PM patients (P< 0.001).Skin lesions mainly located in the head, face, body cadres and limbs end, early performance for papule or herpes, uplift in the skin surface, to the late development such as umbilical concave sample necrosis of the central sag.(3) HIV/TB patients with type Ⅲ pulmonary tuberculosis, (85.71%), secondly for type Ⅱ pulmonary tuberculosis (8.92%) and then Ⅳ pulmonary tuberculosis (5.35%).HIV/TB/PM patients with type Ⅲ pulmonary tuberculosis mainly(86.02%). Secondly, for type Ⅱ pulmonary tuberculosis (3.32%), and then the type Ⅳ tuberculosis 10.75%. There was no significant difference between the two groups in the groups of tuberculosis, and some patients were mixed with two types of tuberculosis. (4) HIV/PM and HIV/TB/PM were Penicillium marneffei diseases.(5) T CD4 lymphocytes in the three groups were statistically significant (P< 0.001). HIV/TB group [(101.0 (166)/mm3] higher than the HIV/PSM group [24.0 (46)/mm3],and HIV/TB/PM group [20.5 (46.25) /mm3] (P< 0.05), there was no significant difference between the HIV/PM group and the HIV/TB/PM group.(6) HIV/TB lung CT lesions is patchy (56.2%), cord like (39.2%), pleural effusion (21.4%), pleural thickening (17.8%), grinding glass (16.1%); HIV/PM lung CT lesions is patchy (55.3%), cord like (20.3%), ground glass opacity (15.3%), nodular (15.2%), pericardial effusion (11.9%); HIV/TB/PM CT of the lungs main pathological characteristics of patchy (44.1%), nodular (18.3%), pleural effusion (16.1%), mediastinal lymph node enlargement (13.9%), cavity, calcification (5.4%).Conclusion Because of the HIV/AIDS infection, can cause the CD4+T cell damage, caused the severe immunosuppressive patients, and get AIDS patients with opportunistic infections such as TB, PSM, TB/PSM. This topic research shows that:1). In different HIV/TB and HIV/PSM, HIV/TB/PSM group found that CD4+T cells have obvious downward trend, especially the multiple infections.2). Mainly Clinical are fever, cough, fatigue, shortness of breath, angular for performance, some of the PSM umbilical concave central necrosis in patients with characteristic skin lesions.3). Imaging is diverse, main show are patchy, funicular, pleural effusion, pleural thickening. Therefore, strengthening the opportunistic infection of AIDS clinical, radiological diagnosis research, lays the foundation for continuing antiretroviral treatment has the profound significance.