OBJECTIVESTo study the progression of cirrhosis in patients with HIV/HCV coinfection.

METHODSThe patients were divided into two groups, HIV/HCV coinfection group (n = 140) and simple HCV infection group (n = 33). A retrospective study was designed to compare the development of cirrhosis in a 15-year period between the two groups.

RESULTSThe development of cirrhosis in the HIV/HCV coinfection group was higher than that in the simple HCV infection group (16.4% vs. 3.0%, P=0.045). Counts of CD4+ T and CD8+ T in the HIV/HCV group were 200.0+/-134.1 cells/microl and 880.6+/-444.2 cells/microl, respectively. The counts of CD4+ T and CD8+ T in the group of simple HCV infection were 752.3+/-251.7 cells/microl and 529.0+/-170.7 cells/microl, respectively. There were significant differences between the two groups regarding the counts of CD4+ T and CD8+ T. Comparing the cases of HCV RNA (+) and anti-HCV (+) with the cases of HCV RNA (+) and anti-HCV (-), we found that the ratio was 89 to 15 in the group of HIV/HCV coinfection, and 25 to 0 in the group of simple HCV infection. The difference between the two groups was statistically significant (P = 0.043).

CONCLUSIONHIV/HCV coinfection can accelerate the progression of cirrhosis, which may be due to the effect of HIV on cellular immunity and humoral immunity.

Adult ; CD4-CD8 Ratio ; China ; epidemiology ; Female ; HIV Infections ; complications ; immunology ; HIV-1 ; Hepatitis C ; complications ; immunology ; Humans ; Liver Cirrhosis ; complications ; epidemiology ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome