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Objective@#To investigate the clinical features and reliable diagnostic method in HIV/AIDS patients with smear negative pulmonary tuberculosis (TB).@*Methods@#Clinical data of 112 HIV/AIDS patients complicated with smear negative pulmonary TB who were treated in our hospital from January 2013 to September 2015 were retrospectively analyzed. These clinical data includeded clinical symptom, blood routine test, blood biochemistry, T lymphocyte subsets classification, sputum acid-fast bacillus smear, mycobacterium tuberculosis culture, purified protein derivatives tuberculin (PPD) test, interferon gamma-release assay for Mycobacterium tuberculosis (T-SPOT.TB), TB-DNA and chest computed tomography (CT). Diagnostic specificity and sensitivity of these parameters were analyzed.@*Results@#No specific clinical manifestation of these patients was identified. The chest CT feature was also atypical. The positive rates including T-SPOT, TB, TB-DNA and PPD test were all low. The positive rates of T-SPOT.TB and PPD test in patients with a CD4+ cell count >200 cells/μl was significantly higher than that of patients with a CD4+ cell count ≤50 cells/μl and 51≤CD4≤200 cells/μl (P<0.01).@*Conclusions@#The clinical feature of smear negative pulmonary TB in HIV/AIDS patients is atypical. For a definite diagnosis, a comprehensive analysis with clinical manifestations, laboratory test, imaging examination and etiologic detection is required.
ABSTRACT
ObjectiveTo investigate the expression of T lymphocytes and activated subsets in patients with HIV/AIDS and early latent syphilis. MethodsT lymphocytes and activated subsets ( HLADR+ CD3 +/CD3 + , HLA-DR+ CD4 +/CD4 + and HLA-DR+ CD8 +/CD8 + ) as well as rapid plasma reagin (RPR) and treponema pallidum particle agglutination (TPPA) test were detected by flow cytometry in 78 patients with HIV/AIDS, 66 patients with HIV/AIDS and early latent syphilis, and 30 healthy subjects. SPSS 13.0 was used for statistical analysis, and t (for normal distribution) or Mann-Whitney U (for skew distribution) tests were performed to compare between the groups. ResultsThe absolute counts of CD4+ T cells in patients with HIV/AIDS and early latent syphilis were significantly higher than those in HIV/AIDS patients ( t = 2. 041 and 2. 223, P ＜ 0.05 ), but no difference in the counts of CD3 + T cells and CD8 + T cells was observed (tcD3 =0. 362 and 0.692, tcD8 =0.043 and 0.617, P＞0.05). HLA-DR+ CD4 +/CD4 +level in AIDS plus syphilis group was much higher than that in HIV plus syphilis group ( t = 2. 647, P ＜ 0. 05 ), but no difference was observed in HLA-DR+ CD3 +/CD3 + and HLA-DR+ CDs +/CDs + ( t = 1. 112 and 0. 093, P ＞ 0.05). ConclusionsImmune function in patients with HIV/AIDS and early latent syphilis may be enhanced temporarily.
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OBJECTIVE To discuss the infection rate of Chlamydia trachomatis(Ct) and Ureaplasma urealyticum(Uu) in patients with non-gonococcal infection.METHODS Fluorescence quantitative PCR method was used on 1025 cases and 30 cases of NGU patients for Ct and Uu detection.RESULTS Of 1025 NGU patients,positive Ct alone accounted for 156 cases,the positive rate was 15.22%.505 cases were separate Uu,the positive rate was 49.27%.Ct,Uu mixed in 217 cases,the positive rate was 21.17%.The detection rate was 85.66%.Uu infection rate in women was more than that in men(?2 = 104.56 P0.05).of control group,the Ct Uu Results negative.CONCLUSIONS In NGH patients,Uu is most common pathgen in man and woman.To diagnosis of NGU,Uu and Ct should be followed by Ct infection rate but no gender tested at the same time to avoid missed diagnosis.