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Objective To study the drug resistance situation of Mycobacterium tuberculosis strains isolated from the patients with HIV/AIDS complicating tuberculosis (TB).Methods One hundred and ninety-six inpatients with AIDS complicating TB in our hospital from January 2012 to December 2015 were collected.The drug resistance situation of Mycobacterium tuberculosis strains cultured from sputum/tissue fluid/fiber liquid and pathological tissue submitted samples in the patients with AIDS complicating active TB was analyzed.The BACTEC MGIT960 systems was adopted to perform the bacterial identification.The drug sensitivity test was conducted by using 960 culture testing system.Results One hundred and ninety-six strains of Mycobacterium tuberculosis were cultured,the total drug resistance rate of Mycobacterium tuberculosis was 26.02％.These cases were divided into the ＞100/μL and ≤100/μL groups according to different CD4+ T cells count.The drug resistance situation of Mycobacterium tuberculosis to 4 kinds of first line anti-TB drugs were compared between these two groups.The comparison results found that the resistance rate of Mycobacterium tuberculosis strains to the first line anti-TB drugs had no statistical difference between the two groups (P＞0.05).The resistance rates of first line anti-TB drugs from high to low were isoniazid,rifampicin,streptomycin and ethambutol.The drug resistance rate of Mycobacterium tuberculosis strains to 5 types of drug resistant TB had no statistical difference(P＞0.05).Conclusion The drug resistance rate in the initial patients with HIV complicating TB is consistent with the average initial drugresistance level of TB patients in our country.The TB drug resistance rate in the patients with HIV complicating TB has no correlation with CD4+ T cells count.
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Objective To study clinical characters and prognosis of AIDS patients with opportunistic infections in Sichuan prov-ince .Methods We performed an retrospective analysis of 1 465 AIDS patients with opportunistic infections who were admitted into the transmitted disease hospital of Chengdu in recent 10 years .Results The overall mortality during hospitalization was 15 .49% . The leading cause of death was respiratory failure due to pneumonia (n=150 ,74 .62% ) or meningitis(n=47 ,23 .86% ) .Descending rank order of common opportunistic infections were respiratory tract ,the mouth swallows ,central nervous system ,gastrointestinal tract skin ,blood system .Descending rank order of common sites of infections were respiratory tract ,oropharynx ,central nervous system ,gastrointestinal tract skin ,reproductive tract .The multiple infections are common :more than 50% of patients suffering from two or more infections(50 .77% ) .Complexity of infection sites :42 .18% dual infection sites and 17 .20% three or more infec-tion sites .Conclusion The opportunistic infections disease spectrum of AIDS in Sichuan area has its own characteristics :multiple infections and multiple infections sites are both common ,death risks are high ,conditions of patients are severe generally ,and respir-atory failure is the main cause of death .
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Objective To compare the difference of immune responses to hepatitis B virus (HBV) vaccine in human immunodeficiency virus (HIV)-1-infected patients with different CD4+ T-lymphocyte counts.Methods HIV-1-infected patients who visited clinic at the Public Health Clinical Center of Chengdu were enrolled and divided into two groups according to CD4+ T-lymphocytes counts.CD4+ T-lymphocytes ＜200/μL,which were and ≥200/μL.All patients were injected intramuscularly with 20 μg of HBV vaccine at month 0,1 and 6,respectively.Vaccination responses were measured at1 and 7 months after first dose.The serum anti-hepatitis B sarface antigen titers of ≥ 10 mIU/mL were considered positive.The serum anti-HBs positive rates was compared by Chi-square test and anti-HBs titers was compared by Mann-Whitney test.Results Ninety-five HIV-1-infected patients were finally enrolled into the analysis,with 55 patients in group of CD4+ T-lymphocytes ＜200/μL and 40 patients in group of CD4+ T-lymphocytes ≥200/μL.The serum anti-HBs positivity rates at 1 and 7 months after first dose in group of CD4+ T-lymphocytes ＜200/μL were 40.0％ (22/55) and 50.9％ (28/55),respectively,which were 47.5％ (19/40) and 75.0％ (30/40) in group of CD4+ Tlymphocytes ≥200/μL.There was no significant difference of serum anti-HBs positivity rates between two groups after 1 month (x2 =5.652,P=0.017).But a significant higher positivity rate was found in group of CD4+ T-lymphocytes ≥200/μL than in group ofCD4+ Tlymphocytes＜200/μL after 7 months (x2=0.531,P=0.466).The median titers of anti-HBs at 7 months were 10.44 mIU/mL in grouP of CD4+ T-lymphocytes ＜ 200/μL and 222.73 mIU/ml in group of CD4+ T-lymphocytes ≥200/μL.There was significant difference of anti-HBs titers between two groups (Z=-3.600,P＜0.01).No patients experienced side effects to HBV vaccine.Logistic regression model analysis indicated that only CD4+ Tlymphocytes was related to anti-HBs positivity after HBV vaccination.Conclusions HIV-1-infected patients with CD4+ T-lymphocytes ≥200/μL have higher serum anti-HBs positivity rates and higher anti HBs titers than patients with CD4+ T-lymphocytes ＜200/μL.However,patients with CD4+ T lymphocytes ＜200/μL also have relatively low immune response.Thus,HBV vaccination should be conducted in all these patients at high risk.