Clinical Characteristics and Prognosis of Penicilliosis among Human Immunodeficiency Virus-Infected Patients in Eastern China
Clinical Characteristics and Prognosis of Penicilliosis among Human Immunodeficiency Virus-Infected Patients in Eastern China
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DOI：
10.4269/ajtmh.16-0521
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发表时间：
2017-01-01
影响因子：
3.3
通讯作者：
Lu, Hongzhou
中科院分区：
文献类型：
--
作者：
Chen, Jun;Zhang, Renfang;Lu, Hongzhou
在中国东部非流行区，越来越多的人感染人类免疫缺陷病毒（HIV），观察到马尔尼菲踝节菌感染。本研究的目的是通过介绍该地区HIV感染者中青霉病的临床特点和预后，引起临床医生对该病的重视。我们回顾性分析了培养证实T。2014年1月1日至2015年12月31日，上海市公共卫生临床中心收治马尔尼菲感染。共纳入48例确诊为HIV感染和青霉病的患者，占中国东部地区每年HIV感染住院患者的平均3.2%（95%置信区间：2.4-4.2%）。症状包括发烧、咳嗽和胃肠道不适，而最常见的体征是皮肤病变。贫血发生率为87.5%（42/48）。总死亡率为16.7%。低CD 4 T细胞计数和血红蛋白水平与死亡率相关。基于这些结果，我们得出结论，在中国东部地区出现发热、皮肤损害和贫血的HIV感染患者中，应考虑青霉素病。其临床特点和预后与流行区相似。对于CD 4 T细胞计数和/或血红蛋白水平低的青霉病患者应给予更多关注。
Talaromyces marneffei infection is increasingly observed in people living with human immunodeficiency virus (HIV) in eastern China, a nonendemic area. This study aimed to draw the clinician's attention to this disease by presenting the clinical characteristics and prognosis of penicilliosis among HIV-infected patients from this region. We retrospectively analyzed HIV-infected patients with culture-proven T. marneffei infection admitted during January 1, 2014-December 31, 2015, at the Shanghai Public Health Clinical Center. A total of 48 patients with confirmed HIV infection and penicilliosis were enrolled, which accounted for a mean of 3.2% (95% confidence interval: 2.4-4.2%) of yearly HIV infection admissions among patients from eastern China. Symptoms included fever, cough, and gastrointestinal complaints, whereas the most common sign was skin lesions. Anemia occurred in 87.5% (42/48) of the patients. The overall mortality rate was 16.7%. Low CD4 T-cell count and hemoglobin level were correlated with mortality. Based on these results, we concluded that penicilliosis should be considered in HIV-infected patients from eastern China who present with fever, cutaneous lesions, and anemia. The clinical characters and the prognosis of patients with penicilliosis are similar to those in endemic areas. More attention should be paid to penicilliosis patients with low CD4 T-cell count and/or low hemoglobin level.