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目的了解云南省德宏州无抗病毒治疗史的成年HIV感染者机会性感染相关症状发生及处理。方法回顾性调查德宏州≥18岁无抗病毒治疗史的HIV感染者于2012年1~9月间机会性感染相关症状发生及处理。结果共有1 416例参加调查,以男性(75.3%)、≤40岁(74.2%)、少数民族(70.1%)、小学及以下文化程度(70.0%)为主;经性传播及静脉吸毒传播感染HIV者各占约50%;CD4细胞计数平均为478个/μl。133例(9.4%)调查对象观察期间至少出现过一种机会性感染相关症状,以呼吸系统症状罹患率最高(6.0%,85例)。其中,85例(63.9%)仅出现1个系统症状,26例(19.5%)出现2个系统症状,22例(16.5%)则出现≥3个系统症状。多因素Logistic回归分析显示,CD4细胞计数>200个/μl的患者机会性感染相关症状罹患率低于CD4细胞计数较低者。大多数出现机会性感染相关症状患者自购药物处理或不做任何处理。结论德宏州无抗病毒治疗成年HIV感染者特别是CD4细胞计数水平低的患者机会性感染发生率较高,应加强机会性感染防治。
Objective To understand the occurrence and management of opportunistic infections in adult HIV-infected adults without history of anti-virus treatment in Dehong Prefecture, Yunnan Province. Methods Retrospective investigation of the occurrence and management of opportunistic infections in HIV-infected persons aged 18 years or older without treatment of antiviral therapy in Dehong Prefecture from January to September 2012 was retrospectively performed. Results A total of 1 416 participants were enrolled in the survey, mainly men (75.3%), ≤40 years (74.2%), ethnic minorities (70.1%) and primary education and below (70.0%); sexually transmitted and intravenous drug use Each of HIV accounted for about 50%; CD4 cell count averaged 478 / μl. 133 cases (9.4%) had at least one opportunistic infection-related symptom during the observation period, with the highest incidence of respiratory symptoms (6.0%, 85 cases). Among them, 85 cases (63.9%) showed only one systemic symptom, 26 (19.5%) showed two systemic symptoms, and 22 (16.5%) showed ≥3 systemic symptoms. Multivariate logistic regression analysis showed that the incidence of opportunistic infection-related symptoms in patients with CD4 counts> 200 cells / μl was lower than those with lower CD4 cell counts. Most patients with opportunistic infections have self-medication or no treatment. Conclusion There is a high incidence of opportunistic infections in adults without HIV infection, especially in patients with low CD4 count in Dehong Prefecture. Therefore, opportunistic infections should be strengthened.