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

OBJECTIVETo investigate Chinese medical features of acquired immunodeficiency syndrome (AIDS) patients with pulmonary infection.

METHODSUsing cluster analysis method, Chinese medical syndromes of 196 AIDS patients with pulmonary infection were analyzed. The distribution features of each syndrome type were analyzed according to the severity and CD4+ numerical analysis.

RESULTSBasic Chinese medical syndrome types could be summed up as three kinds: exterior invasion of wind heat and phlegm heat obstructing Fei syndrome (61 cases, 31.1%), Fei-Pi deficiency and Fei stagnation of phlegm syndrome (64 cases, 32.7%), Fei-Shen deficiency and yin deficiency induced inner heat syndrome (71 cases, 36.2%). There was statistical difference in the severity degree and the distribution of CD4 among the three syndrome types (P < 0.05).

CONCLUSIONSAIDS patients with pulmonary infection involve Fei, Shen, and Pi. The pathogenic factors were related to "wind", "heat", "phlegm", and "xu". The Chinese medical syndrome distribution was closely correlated with patients' immunity.

Acquired Immunodeficiency Syndrome ; complications ; diagnosis ; epidemiology ; Adolescent ; Adult ; Aged ; Cluster Analysis ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Respiratory Tract Infections ; diagnosis ; epidemiology ; etiology ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis ; Young Adult

AIDS-Related Opportunistic Infections ; diagnosis ; Acquired Immunodeficiency Syndrome ; complications ; Diagnostic Imaging ; methods ; Humans ; Nervous System Diseases ; diagnosis ; etiology

According to HIV/AIDS being infectious and have a very long period of incubation, leading to immune system weakened and infected easily, we summarized its pathmechanism including Yuan Qi deficiency (vigour deficiency)and constraint (Qi depression,blood stagnancy, phlegm coagulation, poison accumulation), consequently treatment principle were raised--cultivates the Yuan and clear blockage. From viscera and Qi, blood, Yin and Yang perspective, we elaborate corresponding clinical application method and train of thought, that cultivating the Yuan method means tonify Qi firstly which emphasizes on the spleen and the kidney; Clear blockage method contains relieving liver for smooth Qi, invigorating spleen to remove phlem, promoting blood circulation and detoxification. In addition, cultivating the Yuan and clear blockage should cooperate closely based on traditional Chinese medicine diffrentiation, tonify deficiency should not used individually and vice verse.
Acquired Immunodeficiency Syndrome ; etiology ; immunology ; therapy ; Humans ; Life Style ; Medicine, Chinese Traditional ; methods ; Qi

In recent years, Chinese medicine have gotten certain experience and made progress on the treatment of AIDS. Focus on AIDS main pathogenic factors of epidemic toxin and key pathogenesis of "epidemic toxin invasion, vital-Qi deficiency", this paper discuss on Chinese medicine theory of AIDS etiology and pathogenesis, and put forward the theory of "preventive treatment of disease" and enhanced the importance of "strengthening body resistance and eliminating evil" in the treatment of AIDS.
Acquired Immunodeficiency Syndrome ; etiology ; physiopathology ; therapy ; virology ; HIV ; physiology ; Humans ; Medicine, Chinese Traditional ; methods

Kaposi sarcoma (KS) is a vascular neoplasm, which is fairly prevalent in acquired immunodeficiency syndrome (AIDS) patients. Mucocutaneous and lymph node involvements are characteristic features of KS in AIDS patients. The involvement of gastrointestinal tract occurs in 40% of KS patients and leads to significant morbidity and mortality. In the highly active antiretroviral therapy (HAART) era, the rate of AIDS related KS has fallen with control of human immunodeficiency virus (HIV) viremia. However, it is still recognized as the primary AIDS-defining illness, and the proportion of AIDS diagnoses made due to KS ranged from 4.1% to 7.5%. In Korea, AIDS-related KS has been report in low rate incidence. Its gastrointestinal involvements are rarely reported. To date, five cases have been recorded in Korea. Herein, we present an additional case of gastrointestinal KS as the AIDS-defining illness and review of the Korean medical literature.
Acquired Immunodeficiency Syndrome/complications/*diagnosis ; Anti-HIV Agents/therapeutic use ; Endoscopy, Digestive System ; HIV Infections/complications/diagnosis/drug therapy ; Humans ; Male ; Middle Aged ; Republic of Korea ; Sarcoma, Kaposi/*diagnosis/etiology/pathology ; Tomography, X-Ray Computed

OBJECTIVETo study the Chinese medicine (CM) syndrome laws of patients with pruritic papular eruption (PPE), thus providing reference for its classification and standard diagnosis.

METHODSUsing multicenter, prospective trials in 346 PPE patients,the correlations between sex, age, infection route, and CD4 levels and CM syndrome patterns were analyzed. The syndrome laws correlated with PPE was studied from the macroscopic and microscopic aspects.

RESULTSThere was no statistical difference in sex, age, or CD4 level among various CM syndrome patterns. There was statistical difference in the infection route among various CM syndrome patterns. Pi-deficiency dampness-accumulation syndrome occurred more in patients infected by blood. Wind production induced by heat in blood syndrome occurred more in those infected by sexual contact. Blood deficiency wind dryness syndrome occurred in those infected by intravenous drug abuse.

CONCLUSIONSWind production induced by heat in blood syndrome, blood deficiency wind dryness syndrome, and Pi-deficiency dampness-accumulation syndrome exist in CM syndrome types of AIDS. There was statistical difference in different infection routes of the distribution of each syndrome type.

Acquired Immunodeficiency Syndrome ; complications ; diagnosis ; Adolescent ; Adult ; Exanthema ; diagnosis ; etiology ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prospective Studies ; Pruritus ; diagnosis ; etiology ; Young Adult

OBJECTIVETo establish the diagnosis and treatment standard operating procedure of Chinese medicine for HIV/AIDS diarrhea and to carry out preliminary assessment.

METHODSUnder the guidance of Chinese medical theory, domestic and foreign literatures correlated to the diagnosis and treatment of HIV/AIDS diarrhea by Chinese medicine were summarized. The specialist questionnaire of clinical diagnosis and treatment standard operating procedures of Chinese medicine for HIV/AIDS diarrhea was designed by focus group discussions, and the national specialist questionnaire survey was carried out twice.

RESULTSThe standard operating procedure of clinical diagnosis, treatment, nursing,and therapeutic efficacy assessment of Chinese medicine for HIV/AIDS diarrhea was preliminarily established.

CONCLUSIONSIn the regulations, the concepts of the disease and symptoms and their pathogenesis were defined, and the standardization of Chinese medicine diagnosis and treatment was highlighted. Meanwhile, emphasized were the features of propaganda and education, follow-ups, consecutive diagnosis and treatment outside or inside hospitals.

Acquired Immunodeficiency Syndrome ; complications ; diagnosis ; drug therapy ; Adult ; Diarrhea ; diagnosis ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; standards ; Middle Aged ; Phytotherapy ; Surveys and Questionnaires

BACKGROUNDCytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS). This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.

METHODSIt was a retrospective case series. CMV retinitis was present in 39 eyes (25 patients). Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography (FFA) and CD4(+) T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir (400 µg) were performed in 4 eyes (2 patients).

RESULTSRetinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque. Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium (RPE) atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4(+) T-lymphocyte count in peripheral blood of the patients with CMV retinitis was (30.6 ± 25.3) × 10(6)/L (range, (0 - 85) × 10(6)/L). After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.

CONCLUSIONSCMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus (HIV) serology should be performed. Routine eye examination is also indicated in HIV positive patients.

Acquired Immunodeficiency Syndrome ; complications ; immunology ; metabolism ; Adult ; Antiviral Agents ; pharmacology ; CD4-Positive T-Lymphocytes ; metabolism ; Cytomegalovirus Retinitis ; drug therapy ; etiology ; immunology ; metabolism ; Female ; Fluorescein Angiography ; Ganciclovir ; pharmacology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

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