Acquired Immunodeficiency Syndrome ; complications ; epidemiology ; Africa ; epidemiology ; Clinical Trials as Topic ; Humans ; International Cooperation ; Neoplasms ; epidemiology ; etiology ; therapy ; Treatment Outcome

Cytomegalovirus retinitis (CMVR) is the commonest opportunistic ocular infection in patients with human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS), typically occurs when CD4+ T cell counts fall below 50/mm3. CMVR accounts for the majority of the vision loss associated with HIV-related eye diseases. However progress in the studies on CMVR, including the prevalence, clinical features, differential diagnosis and recent advances in the management of CMVR is reviewed.
Acquired Immunodeficiency Syndrome ; complications ; CD4 Lymphocyte Count ; Cytomegalovirus Retinitis ; diagnosis ; epidemiology ; therapy ; Diagnosis, Differential ; HIV Infections ; complications ; Humans

OBJECTIVETo investigate the features of oral lesions in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS).

METHODSA total of 127 HIV-seropositive patients were interviewed for health information and examined for their HIV-related oral lesions according to the EC Clearing House Criteria on Oral Problems related to HIV-Infection (1992). The examinations were conducted by dental specialist and HIV specialist. The CD4 T cell count in peripheral blood of the patients was tested by flow cytometry. The patients were divided into HIV- infected group (42) and AIDS group (85) according to CDC Classification System for HIV- Infected Adults and Adolescents (revised in 1993). Chi-square test was used to test the relationship between systemic disease and oral lesions, and the difference of the prevalence of oral lesions between the two groups.

RESULTSAmong the 127 patients, oral candidiasis (51/127), oral hairy leukoplakia (24/127) were common oral manifestation. There was no relationship between the oral manifestation and systemic disease (P = 0.397). The occurrence of oral lesions and oral candidiasis was significantly different between the two groups (χ² = 7.684, P = 0.006; χ² = 14.410, P < 0.001). The CD4 count was related to the prevalence of oral lesions (P = 0.006) and oral candidasis (P = 0.003).

CONCLUSIONSMost oral lesions appeared before the appearance of systemic disease. Oral candidiasis and oral hairy leukoplakia were the most common lesions.Oral lesions had no relationship with systemic disease but could be still an indicator for disease progress.

Acquired Immunodeficiency Syndrome ; complications ; CD4 Lymphocyte Count ; CD4-Positive T-Lymphocytes ; Candidiasis, Oral ; epidemiology ; China ; epidemiology ; HIV Infections ; Humans ; Leukoplakia, Hairy ; Mouth Diseases ; complications ; epidemiology ; Prevalence

Toxoplasmosis, a neglected tropical disease caused by the protozoan parasite Toxoplasma gondii, occurs throughout the world. Human T. gondii infection is asymptomatic in 80% of the population; however, the infection is life-threatening and causes substantial neurologic damage in immunocompromised patients such as HIV-infected persons. The major purpose of this study was to investigate the seroprevalence of T. gondii infection in subjects infected with HIV/AIDS in eastern China. Our findings showed 9.7% prevalence of anti-T. gondii IgG antibody in HIV/AIDS patients, which was higher than in intravenous drug users (2.2%) and healthy controls (4.7%), while no significant difference was observed in the seroprevalence of anti-Toxoplasma IgM antibody among all participants (P>0.05). Among all HIV/AIDS patients, 15 men (7.7%) and 10 women (15.9%) were positive for anti-T. gondii IgG antibody; however, no significant difference was detected in the seroprevalence of anti-Toxoplasma IgG antibody between males and females. The frequency of anti-Toxoplasma IgG antibody was 8.0%, 13.2%, 5.5%, and 0% in patients with normal immune function (CD4+ T-lymphocyte count ≥500 cells/ml), immunocompromised patients (cell count ≥200 and <500 cells/ml), severely immunocompromised patients (cell count ≥50 and <200 cells/ml), and advanced AIDS patients, respectively (cell count <50 cells/ml), while only 3 immunocompromised patients were positive for anti-T. gondii IgM antibody. The results indicate a high seroprevalence of T. gondii infection in HIV/AIDS patients in eastern China, and a preventive therapy for toxoplasmosis may be given to HIV/AIDS patients based on CD4+ T lymphocyte count.
Acquired Immunodeficiency Syndrome/complications ; Antibodies, Protozoan/*blood ; China/epidemiology ; Female ; HIV Infections/*complications ; Humans ; Immunocompromised Host ; Male ; Seroepidemiologic Studies ; Toxoplasma ; Toxoplasmosis/*complications/*epidemiology

Along with the rapid spread of HIV / AIDS and TB prevalence, prevention and control of AIDS and tuberculosis has become an urgent problem in the field of public health. Recent studies demonstrate dual infections of HIV and TB are not a simple superposition of two diseases, but a course of mutual promotion. This article has summarized the pathological mechanisms and mutual interactions of HIV/TB dual infections.
Acquired Immunodeficiency Syndrome ; complications ; epidemiology ; prevention & control ; Coinfection ; HIV-1 ; pathogenicity ; Humans ; Mycobacterium tuberculosis ; pathogenicity ; Prevalence ; Public Health ; Tuberculosis ; complications ; epidemiology ; prevention & control

OBJECTIVETo analyze the clinical features of 128 acquired immunodeficiency syndrome (AIDS) patients infected through blood transmission who were coinfected with hepatitis B virus (HBV) and hepatitis C virus (HCV).

METHODSThe prevalence, liver functions, and some immunological profiles of 128 AIDS patients coinfected with HBV and HCV were retrospectively analyzed.

RESULTSAmong the 128 AIDS patients, 107 (83.6%) were coinfected with HCV, among which 40 (31.3%) patients had abnormal liver functions or liver damage and 15 (11.7%) patients experienced hepatitis symptoms. Three (2.3%) AIDS patients were singly coinfected with HBV, and all of them had abnormal liver functions and hepatitis symptoms. Seven (5.5%) patients were coinfected with HIV/HCV/HBV and none of them had abnormal liver functions or hepatitis symptoms. Eleven (8.6%) patients were only infected with HIV.

CONCLUSIONSThe prevalence of blood-transmitted HIV patients coinfected with HCV is higher than with HBV. The clinical outcomes of HIV coinfection with HCV and HBV are different.

Acquired Immunodeficiency Syndrome ; complications ; Adolescent ; Adult ; Aged ; China ; epidemiology ; Comorbidity ; Female ; Hepatitis B ; epidemiology ; Hepatitis C ; epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Transfusion Reaction

PURPOSE: To investigate the patterns and risk factors of the ocular manifestations of acquired immunodeficiency syndrome (AIDS) and their correlation with CD4+ count in the era of highly active antiretroviral therapy (HAART). METHODS: This retrospective study examined 127 AIDS patients who presented to Soonchunhyang University Hospital. Data were collected from patient interviews, clinical examinations, and laboratory investigations. Ophthalmologic examinations included the best-corrected visual acuity, intraocular pressure, anterior segment and adnexal examination, and dilated fundus examination. RESULTS: Of the 127 patients with AIDS, 118 were on HAART and 9 were not. The mean CD4+ count was 266.7 +/- 209.1 cells/microL. There were ocular manifestations in 61 patients (48.0%). The incidence of anterior segment manifestations was higher than posterior segment manifestations at 28.3% and 19.7%, respectively. The mean CD4+ count was significantly (p < 0.05) lower in the patients with posterior versus anterior segment ocular manifestations. The most common ocular manifestation was retinal microvasculopathy (15.0%), followed by keratoconjunctivitis sicca (14.2%), conjunctival microvasculopathy (9.4%), cytomegalovirus retinitis (3.1%), herpes zoster ophthalmicus (2.4%), and blepharitis (1.6%). Retinal microvasculopathy and cytomegalovirus retinitis were common in patients with CD4+ counts <200 cells/microL, while keratoconjunctivitis sicca and conjunctival microvasculopathy were common in patients with CD4+ counts of 200 to 499 cells/microL. There was a significant (p < 0.05) association between ocular manifestation and CD4+ count or age. CONCLUSIONS: The introduction of HAART has changed the landscape of ocular presentations in patients with AIDS. In this study, anterior segment and external ocular manifestations occurred more frequently than posterior segment manifestations. Also, the mean CD4+ count was significantly lower in patients with posterior segment ocular manifestations versus anterior segment ocular manifestations. We found that CD4+ count and age >35 years were independent risk factors for developing ocular manifestations.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Aged ; Eye Diseases/diagnosis/epidemiology/*etiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Visual Acuity ; Young Adult

HIV infection/AIDS shows characteristic epidemiological and clinical patterns according to the region, country, and race. The epidemiological and clinical patterns of HIV infection/ AIDS in Korea was investigated by retrospectively analyzing the medical records of 176 HIV-infected persons who visited two major referral hospitals of AIDS in Korea from 1985 to April 2000. The most common transmission route was heterosexual contact (52.3%), followed by homosexual contact (23.9%). Among the opportunistic diseases, candidiasis was the most prevalent (21.6%), followed by Pneumocystis carinii pneumonia (15.9%), tuberculosis (12.5%), and CMV infection (9.1%). The most common initial AIDS-defining opportunistic disease was tuberculosis (33.3%). The most common causes of death were tuberculosis (25.7%) and Pneumocystis carinii pneumonia (25.7%). This study describes the epidemiological and clinical patterns of HIV infection/AIDS in Korea, which not only enables us to accurately understand HIV infection/ AIDS in this country, but eventually to aid in establishing effective preventive measures and treatment guidelines in Korea.
Acquired Immunodeficiency Syndrome/*complications/*epidemiology ; Adolescent ; Adult ; Female ; Human ; Korea/epidemiology ; Male ; Middle Aged ; Opportunistic Infections/etiology ; Pneumonia, Pneumocystis/mortality ; Prevalence ; Support, Non-U.S. Gov't ; Tuberculosis/mortality

OBJECTIVETo understand the influencing factors on the death of infants born to HIV infected mothers in areas with high prevalence of HIV/AIDS in China.

METHODSBased on the follow-up cohort study targeting at HIV/AIDS infected pregnant women and their babies initiated in 2004, a survey on the death status and influencing factors on the infants born to HIV/AIDS infected mothers enrolled in this cohort from Jan.2004 to Nov.2007 was carried out during Aug.to Nov.2008 in seven counties of four provinces in China. A total of 498 pairs of HIV-infected mothers and their infants were enrolled and their related information was collected. Single factor and multiple factors Cox model methods were adopted for data analysis.

RESULTSThe total observed person-years of 498 infants was 406.22, among which, 45 infants died, and the mortality density was 110.78 per 1000 child-year. A single factor Cox model showed, the pregnancy in pre-period of HIV/AIDS and HIV/AIDS period (RR = 1.971, 95%CI: 1.143 - 3.396), living status of the pregnancy (RR = 3.062, 95%CI: 1.097 - 8.550), multipara women (RR = 0.517, 95%CI: 0.278 - 0.961), natural childbirth (RR = 0.561, 95%CI: 0.345 - 0.910), premature labor (RR = 5.302, 95%CI: 2.944 - 9.547), low birth weight (RR = 4.920, 95%CI: 2.691 - 8.994), mother-child pairs taking antiretroviral drugs (RR = 0.227, 95%CI: 0.121 - 0.428) and infants infected HIV (RR = 5.870, 95%CI: 3.232 - 10.660) could affect the infants death. The death of HIV-exposed infants was influenced by various factors. The death risk of infants born to HIV infected mothers who were in the danger of pre-period of HIV/AIDS and HIV/AIDS period was greater than the infants delivered by HIV infected mothers who were in preclinical period of HIV/AIDS (RR = 6.99, 95%CI: 1.92 - 25.64). The death risks were greater in the group that the women whose CD4(+)TLC count number lower than 200 cells/microl (RR = 2.05, 95%CI: 1.01 - 4.15). The infants whose mothers had no ARV treatment had higher possibility to die than the others (RR = 6.17, 95%CI: 1.62 - 23.26). The death risk of premature delivered infants was 2.87 times of mature delivered infants (95%CI: 1.12 - 7.35). The death risk of HIV/AIDS infected infants was 9.87 times of the HIV/AIDS uninfected infants (95%CI: 3.81 - 25.62).

CONCLUSIONSome measurements including improving HIV-infected pregnant women's immunity, reducing mother to child transmission of HIV and premature birth, low birth weight are beneficial to reducing infant mortality.

Acquired Immunodeficiency Syndrome ; epidemiology ; mortality ; transmission ; Cause of Death ; China ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious ; epidemiology ; Proportional Hazards Models

OBJECTIVETo understand epidemiologic characteristics and changes in epidemic trend of human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) in different areas and populations of Yunnan Province.

METHODSSeroepidemiological studies were conducted in injection drug users (IDUs), women sex workers, whoring goers, patients with sexually transmitted disease (STD), patients with tuberculosis, pregnant women and blood donors with sentinel surveillance, ad hoc investigations, regular case-finding and data collection during 1989 to 2003 in Yunnan Province.

RESULTSRelatively high prevalence of HIV/AIDS was firstly found in IDUs from border areas of the province in 1989. By December of 2003, totally 14 905 cases with HIV infection were reported in 121 counties of 16 prefectures in Yunnan Province. Prevalence of HIV infection ranged from 21.2% to 27.8% in IDUs, over 40% in IDUs from six areas, and 1.23% to 6.67% and 0.3% to 1.8% in underground prostitutes and whoring goers, respectively. Prevalence of HIV infection was 2.1% to 2.7%, 10.8% in specific areas, in male patients with STD, and was 0.14% to 0.25% in pregnant women during 1993 to 2002 and increased to 0.37% in 2003. Prevalence of HIV infection ranged 1.5% to 1.6% in patients with tuberculosis and 0.01% in blood donors during 1999 to 2000 and increased to 0.07% in 2003.

CONCLUSIONSEpidemic of HIV infection began in late 1980s in Yunnan, then spread from border areas to inland through IDUs, maintaining a higher prevalence in them to date. Sexual transmission of HIV/AIDS showed an increasing trend in them, with a low prevalence in general population, but appeared a wide spread in local areas.

Acquired Immunodeficiency Syndrome ; epidemiology ; Adult ; China ; epidemiology ; Female ; HIV Infections ; epidemiology ; HIV Seroprevalence ; HIV-1 ; Humans ; Male ; Prevalence ; Risk-Taking ; Sentinel Surveillance ; Sexually Transmitted Diseases ; epidemiology ; Substance Abuse, Intravenous ; complications ; epidemiology ; Surveys and Questionnaires