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Clinical Features of Acquired Immunodeficiency Syndrome in Respiratory Department
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A5532 - Clinical Features of Acquired Immunodeficiency Syndrome in Respiratory Department
Author Block: Y. Zhou, L. Huiping; Shanghai Pulmonary Hospital, Shanghai, China.
Introduction: Pulmonary infection is the most common opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS), including Pneumocystis carinii (PCP), pulmonary tuberculosis and other infection. When AIDS complicated with pulmonary infection, the clinical symptoms were severe and the mortality rate was high. The object of this study is to investigate the clinical manifestations, immunological characteristics and imaging features of AIDS in the Department of respiration, and to improve the awareness of these diseases for respiratory physician. Methods: The general data, clinical manifestation, laboratory examination, imaging examination and treatment of 88 AIDS patients from January 2014 to December 2016 in Shanghai Pulmonary Hospital were collected. The AIDS diagnostis was according to the criteria of WS293-2008 AIDS and HIV infection. The clinical diagnostic criteria of PCP included HIV/AIDS diagnosis; CD4+T lymphocyte count below 200 /ul; chronic fever, cough, dyspnea, cyanosis, hypoxemia; chest X-ray showed interstitial pneumonia, or CT examination with pulmonary ground glass opacities; and SMZ-TMP responded well to treatment. Results: 88 patients were confirmed by preliminary screening and confirmatory test (Shanghai CDC test), and the HIV antibody was positive, and met the AIDS diagnostic criteria. There were 80 males and 8 females with an age of 20-79 years and a median age of 46.5 years. CD4+T/CD8+T lymphocytes were detected by flow cytometry in 79 patients. 75(94.9%) patients had CD4+T lymphocyte decline (medium 8.3%). The ratio of CD4+/CD8+T lymphocytes in 76 (96.2%) patients decreased significantly(medium 0.18). This group of 88 patients were first manifested with respiratory symptoms. Cough(64, 84.2%), shortness of breath(49, 64.5%), fever(48, 64.2%) was the main clinical symptoms. The most common opportunistic pulmonary infection was PCP, followed by tuberculosis and fungal infection. Among them, 43 cases were complicated with PCP (48.9%), 28 cases were tuberculosis infection (31.8%) and 22 cases were fungal infection (25%).Diffuse ground glass opacification of the lung was the main CT imaging manifestation, accounting for 39.8% (35) of these 88 patients and 76.7% (33/43) of PCP infected patients. Conclusion: The clinical manifestation of Cough, shortness of breath, fever symptoms with chest CT feature of two lung diffuse ground glass shadow, the diagnosis of AIDS should be suspected in respiratory department. HIV antibodies and CD4+T lymphocytes need to be tested for further confirmation.
Author Block: Y. Zhou, L. Huiping; Shanghai Pulmonary Hospital, Shanghai, China.
Introduction: Pulmonary infection is the most common opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS), including Pneumocystis carinii (PCP), pulmonary tuberculosis and other infection. When AIDS complicated with pulmonary infection, the clinical symptoms were severe and the mortality rate was high. The object of this study is to investigate the clinical manifestations, immunological characteristics and imaging features of AIDS in the Department of respiration, and to improve the awareness of these diseases for respiratory physician. Methods: The general data, clinical manifestation, laboratory examination, imaging examination and treatment of 88 AIDS patients from January 2014 to December 2016 in Shanghai Pulmonary Hospital were collected. The AIDS diagnostis was according to the criteria of WS293-2008 AIDS and HIV infection. The clinical diagnostic criteria of PCP included HIV/AIDS diagnosis; CD4+T lymphocyte count below 200 /ul; chronic fever, cough, dyspnea, cyanosis, hypoxemia; chest X-ray showed interstitial pneumonia, or CT examination with pulmonary ground glass opacities; and SMZ-TMP responded well to treatment. Results: 88 patients were confirmed by preliminary screening and confirmatory test (Shanghai CDC test), and the HIV antibody was positive, and met the AIDS diagnostic criteria. There were 80 males and 8 females with an age of 20-79 years and a median age of 46.5 years. CD4+T/CD8+T lymphocytes were detected by flow cytometry in 79 patients. 75(94.9%) patients had CD4+T lymphocyte decline (medium 8.3%). The ratio of CD4+/CD8+T lymphocytes in 76 (96.2%) patients decreased significantly(medium 0.18). This group of 88 patients were first manifested with respiratory symptoms. Cough(64, 84.2%), shortness of breath(49, 64.5%), fever(48, 64.2%) was the main clinical symptoms. The most common opportunistic pulmonary infection was PCP, followed by tuberculosis and fungal infection. Among them, 43 cases were complicated with PCP (48.9%), 28 cases were tuberculosis infection (31.8%) and 22 cases were fungal infection (25%).Diffuse ground glass opacification of the lung was the main CT imaging manifestation, accounting for 39.8% (35) of these 88 patients and 76.7% (33/43) of PCP infected patients. Conclusion: The clinical manifestation of Cough, shortness of breath, fever symptoms with chest CT feature of two lung diffuse ground glass shadow, the diagnosis of AIDS should be suspected in respiratory department. HIV antibodies and CD4+T lymphocytes need to be tested for further confirmation.
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