A Retrospective Cohort Study of Lesion Distribution of HIV-1 Infection Patients With Cryptococcal Meningoencephalitis on MRI: Correlation With Immunity and Immune Reconstitution.
A Retrospective Cohort Study of Lesion Distribution of HIV-1 Infection Patients With Cryptococcal Meningoencephalitis on MRI: Correlation With Immunity and Immune Reconstitution.
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DOI：
10.1097/md.0000000000002654
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发表时间：
2016-02
期刊：
影响因子：
1.6
通讯作者：
Li H
中科院分区：
文献类型：
--
作者：
Xia S;Li X;Shi Y;Liu J;Zhang M;Gu T;Pan S;Song L;Xu J;Sun Y;Zhao Q;Lu Z;Lu P;Li H
本文旨在探讨HIV-1感染者隐球菌脑膜脑炎的MRI分布与CD 4 T细胞计数及免疫重建效果的关系。为探讨隐球菌脑膜脑炎的MRI分布及其与不同免疫状态的关系，对中国多个HIV中心的HIV患者进行了一项大型回顾性队列研究。回顾性分析2011 - 2014年在中国多个HIV中心收集的55例HIV-1感染合并隐球菌脑膜脑炎患者的连续临床和神经影像学资料。根据病变分布将入组患者分为2组。一组患者的病灶位于中央脑（第1组，n = 34），另一组患者的病灶位于浅表脑（第2组，n = 21）。 探讨其脑部MRI表现。此外，我们还根据影像学检查结果，比较了两组患者的CD 4 T细胞计数和免疫重建效果。两组患者的年龄和性别差异无统计学意义。组1中CD 4 T细胞计数的中位数为11.67个细胞/mm 3（3.00-52.00个细胞/mm 3），组2中为42.00个细胞/mm 3（10.00-252.00个细胞/mm 3）。 两组间CD 4 T细胞计数差异有统计学意义（P = 0.023）。 第1组13例（13/34）和第2组12例（12/21）接受高效抗逆转录病毒治疗（HAART）。第2组患者接受HAART治疗的频率高于第1组（P = 0.021）。 HIV-1感染合并隐球菌性脑膜脑炎患者MR成像发现的中枢和浅表脑病变与宿主免疫和HAART治疗相关。
The objective of this paper is to correlate the MRI distribution of cryptococcal meningoencephalitis in HIV-1 infection patients with CD4 T cell count and immune reconstitution effect. A large retrospective cohort study of HIV patients from multi-HIV centers in China was studied to demonstrate the MRI distribution of cryptococcal meningoencephalitis and its correlation with the different immune status. The consecutive clinical and neuroimaging data of 55 HIV-1-infected patients with cryptococcal meningoencephalitis collected at multi-HIV centers in China during the years of 2011 to 2014 was retrospectively analyzed. The enrolled patients were divided into 2 groups based on the distribution of lesions. One group of patients had their lesions at the central brain (group 1, n = 34) and the other group of patients had their lesions at the superficial brain (group 2, n = 21). We explored their MRI characterization of brain. In addition, we also compared their CD4 T cell counts and immune reconstitution effects between the 2 groups based on the imaging findings. No statistical difference was found in terms of age and gender between the 2 groups. The medians of CD4 T cell counts were 11.67 cells/mm3 (3.00–52.00 cells/mm3) in group 1 and 42.00 cells/mm3 (10.00–252.00 cells/mm3) in group 2. Statistical difference of CD4 T cell count was found between the 2 groups (P = 0.023). Thirteen patients in group 1 (13/34) and 12 patients in group 2 (12/21) received highly active antiretroviral treatment (HAART). Patients of group 2 received HAART therapy more frequently than patients of group 1 (P = 0.021). Central and superficial brain lesions detected by MR imaging in HIV-1-infected patients with cryptococcal meningoencephalitis are in correlation with the host immunity and HAART therapy.