中国北方部分地区人类免疫缺陷病毒合并播散性鸟分枝杆菌复合群感染者的临床特征及预后影响因素

doi:10.20047/j.issn1673-7210.2022.28.22

Abstract
Figure/Table
References (25)
Related Citation (15)

Download: PDF (561 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the clinical characteristics and influencing factor of prognosis factors of human immunodeficiency virus (HIV) with disseminated Mycobacterium avium complex (DMAC) patients in some areas of northern China. Methods The clinical data of HIV with DMAC patients who were hospitalized in Beijing Youan Hospital, Capital Medical University, Tianjin Second People’s Hospital, and Shijiazhuang Fifth Hospital from January 2014 to January 2020 were collected, and the information of HIV with disseminated Mycobacterium tuberculosis (DMTB) patients who were hospitalized in these three hospitals at the same time were also collected. The clinical characteristics of HIV with DMAC patients were compared, and further follow-up was conducted to analyze the influencing factor of prognosis. Results The levels of alkaline phosphatase and γ-glutamyl transpeptidase, the incidence of hepatomegaly, the incidence of splenomegaly, and the initiation rate of anti-retroviral therapy (ART) in HIV with DMAC patients were higher than those in HIV with DMTB patients, the incidence of pleural effusion was lower than that of HIV combined with DMTB infection, and the differences were statistically significant (P ＜ 0.05). The proportion of non-initiated ART, the level of CRP, and HIV viral load in patients who died after HIV with DMAC were higher than those in survival patients, and the level of HGB was lower than that in survival patients, and the differences were statistically significant (P ＜ 0.05). ART initiation, hemoglobin, and C-reactive protein were prognostic factors of HIV with DMAC patients (P ＜ 0.05). Conclusion The clinical and imaging features are helpful for the preliminary differentiation between HIV with DMAC patients and HIV with DMTB patients. ART is of great significance for the prognosis of HIV with DMAC patients.

Key words： Human immunodeficiency virus Disseminated Mycobacterium avium complex Clinical diagnosis Prognosis Influencing factor

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WEI Huaying1* WANG Lijing2* CUI Xiao1 YANG Yang1 CHEN Xue1 MA Ping3 ZHANG Yulin1

Cite this article:

WEI Huaying1* WANG Lijing2* CUI Xiao1 YANG Yang1 CHEN Xue1 MA Ping3 ZHANG Yulin1. Clinical characteristics and influencing factor of prognosis of human immuno-deficiency virus combined with disseminated Mycobacterium avium complex patients in parts of northern China[J]. 中国医药导报, 2022, 19(28): 102-105,110.

URL:

https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2022.28.22 OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I28/102

[1] Jing H，Wang H，Wang Y，et al. Prevalence of nontuberculous mycobacteria infection，China，2004-2009 [J]. Emerg Infect Dis，2012，18（3）：527-528.
[2] Marochi-Telles JP，Muniz RJr.，Sztajnbok J，et al. Disseminated Mycobacterium avium on HIV/AIDS：Historical and Current Literature Review [J]. AIDS Rev，2020，22（1）：9-15.
[3] McCarthy KD，Cain KP，Winthrop KL，et al. Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia [J]. Am J Respir Crit Care Med，2012，185（9）：981-988.
[4] 黄莉莉，陈伟，方刚，等.南京地区非结核分枝杆菌肺疾病临床分离株的菌种鉴定及临床特征分析[J].国际呼吸杂志，2019，39（20）：1537-1542.
[5] 王敬，初乃惠，段鸿飞，等.鸟胞内分枝杆菌复合群肺病患者23例临床分析[J].中华临床医师杂志（电子版），2012，6（24）：8126-8129.
[6] 中华医学会感染病学分会艾滋病丙型肝炎学组，中国疾病预防与控制中心.中国艾滋病诊疗指南（2018版）[J].中华传染病杂志，2018，36（12）：705-724.
[7] Kaplan JE，Benson C，Holmes KK，et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents：recommendations from CDC，the National Institutes of Health，and the HIV Medicine Association of the Infectious Diseases Society of America [J]. MMWR Recomm Rep，2009，58（Rr-4）：1-207.
[8] Morimoto K，Yoshiyama T，Kurashima A，et al. Nutritional indicators are correlated with the radiological severity score in patients with Mycobacterium avium complex pulmonary disease：a cross-sectional study [J]. Intern Med，2014，53（5）：397-401.
[9] Hawkins CC，Gold JW，Whimbey E，et al. Mycobacterium avium complex infections in patients with the acquired immunodeficiency syndrome [J]. Ann Intern Med，1986， 105（2）：184-188.
[10] Cai RT，Yu FX，Tao Z，et al. Routinely detected indicators in plasma have a predictive effect on the identification of HIV-infected patients with non-tuberculous mycobacterial and tuberculous infections [J]. Infect Dis Poverty，2017，6（1）：132.
[11] Hsieh SM，Hung CC，Chen MY，et al. Clinical features and outcome in disseminated mycobacterial diseases in AIDS patients in Taiwan [J]. Aids，1998，12（11）：1301-1307.
[12] Miura K，Nakamura M，Taooka Y，et al. Comparison of the chest computed tomography findings between patients with pulmonary tuberculosis and those with Mycobacterium avium complex lung disease [J]. Respir Investig，2020， 58（3）：137-143.
[13] Koh WJ，Lee KS，Kwon OJ，et al. Bilateral bronchiectasis and bronchiolitis at thin-section CT：diagnostic implications in nontuberculous mycobacterial pulmonary infection [J]. Radiology，2005，235（1）：282-288.
[14] Karakousis PC，Moore RD，Chaisson RE. Mycobacterium avium complex in patients with HIV infection in the era of highly active antiretroviral therapy [J]. Lancet Infect Dis，2004，4（9）：557-565.
[15] Radin DR. Intraabdominal Mycobacterium tuberculosis vs Mycobacterium avium-intracellulare infections in patients with AIDS：distinction based on CT findings [J]. AJR Am J Roentgenol，1991，156（3）：487-491.
[16] Kisembo HN，Boon SD，Davis JL，et al. Chest radiographic findings of pulmonary tuberculosis in severely immunocompromised patients with the human immunodeficiency virus [J]. Br J Radiol，2012，85（1014）：e130-139.
[17] da Silva RM，da Rosa L，Lemos RN. Radiographic alterations in patients presenting human immunodeficiency virus/tuberculosis coinfection：correlation with CD4+ T cell counts [J]. J Bras Pneumol，2006，32（3）：228-233.
[18] dos Santos RP，Scheid KL，Willers DM，et al. Comparative radiological features of disseminated disease due to Mycobacterium tuberculosis vs non-tuberculosis mycobacteria among AIDS patients in Brazil [J]. BMC Infect Dis，2008，8：24.
[19] Richter C，Perenboom R，Mtoni I，et al. Clinical features of HIV-seropositive and HIV-seronegative patients with tuberculous pleural effusion in Dar es Salaam，Tanzania [J]. Chest，1994，106（5）：1471-1475.
[20] Ganz T. Anemia of Inflammation [J]. N Engl J Med，2019， 381（12）：1148-1157.
[21] Isanaka S，Mugusi F，Urassa W，et al. Iron deficiency and anemia predict mortality in patients with tuberculosis [J]. J Nutr，2012，142（2）：350-357.
[22] Gil-Santana L，Cruz LAB，Arriaga MB，et al. Tuberculosis-associated anemia is linked to a distinct inflammatory profile that persists after initiation of antitubercular therapy [J]. Sci Rep，2019，9（1）：1381.
[23] Manosuthi W，Chaovavanich A，Tansuphaswadikul S，et al. Incidence and risk factors of major opportunistic infections after initiation of antiretroviral therapy among advanced HIV-infected patients in a resource-limited setting [J]. J Infect，2007，55（5）：464-469.
[24] Collins LF，Clement ME，Stout JE. Incidence，Long-Term Outcomes，and Healthcare Utilization of Patients With Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Disseminated Mycobacterium avium Complex From 1992-2015 [J]. Open Forum Infect Dis，2017，4（3）：ofx120.
[25] Djawe K，Buchacz K，Hsu L，et al. Mortality Risk After AIDS-Defining Opportunistic Illness Among HIV-Infected Persons--San Francisco，1981-2012 [J]. J Infect Dis，2015，212（9）：1366-1375.