[Clinical Epidemiological Characteristics of Newly Reported HIV/AIDS in a Certain General Hospital from 2001 to 2017].

OBJECTIVE: To determine the clinical epidemiological characteristics of newly reported human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS）in southwestern China from 2001 to 2017. METHODS: Clinical data of newly diagnosed HIV/AIDS from 2001 to 2017 in the West China Hospital of Sichuan University were reviewed and analyze. RESULTS: A total of 1 520 228 patients were screened for HIV, including 285 983 outpatient and emergency patients and 1 234 245 inpatients. About 4 037 (0.27%) patients were confirmed with HIV/AIDS. The confirmation rate increased from 2001 to 2013, followed by a slight decline from 2014 to 2017. The male to female sex ratio of confirmed HIV/AIDS was 3.49:1 from 2001 to 2017, ranging from 1.65:1 to 5.08:1. The majority of patients were identified as Han (88.23%), had low education (58.66%), and married (54.75%). Peasants/herdsman comprised 26.33% of the patients. The proportion of young (15-29 years old), and middle-aged (≥50 years old) patients and those who were unmarried and had high education (senior high school and above) increased over time. Heterosexual transmission remained stable at about 60% while homosexual transmission increased by about 15% ( χ 2=14.436, P＜0.005) since 2008. Transmissions through drug abuse( χ 2=71.633, P＜0.005) and blood( χ 2=16.672, P＜0.005) decreased. Of the 899 female newly reported HIV/ADIS patients, 77.20% were infected through heterosexual relationship. In comparison, of the 3 138 male patients, 61.41% were infected through heterosexual and 18.10% through homosexual relationships. Homosexual transmissions decreased with age, but heterosexual transmissions increased with age. Mother-to-child transmissions were concentrated in those between 0 and 15 years old (100%). CONCLUSION: Newly diagnosed HIV/AIDS cases increased over the years in the West China Hospital of Sichuan University, in particular in those of young and middle-aged, highly educated and unmarried. Heterosexual transmissions remain the main route.

[Galactomannan Tests of Bronchoalveolar Lavage Fluid for Diagnosing Invasive Pulmonary Aspergillosis].

OBJECTIVE: To determine the value of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) for diagnosing invasive pulmonary aspergillosis. METHODS: According to the European Organization for Research and Treatment of Cancer / Invasive Fungal Infection Group (EORTC / IFICG) and the American Mycosis Research Group (MSG),and the American College of Infectious Diseases (IDSA) guidelines,295 patients with pulmonary aspergillosis (IPA) and high risk of invasive infections were divided into four groups: IPA group (42 cases),clinically diagnosed group (68 cases),suspected group (61 cases),and non-IPA group (124 cases). Their serum and BALF concentrations of GM were detected by enzyme-linked immunosorbent assay (ELISA).The clinically diagnosed and confirmed invasive pulmonary fungal infections (IPFI) were treated as golden standards (+). A GM value ≥ proposed threshold was deemed diagnostic test positive. Receiver operating characteristic (ROC) curves were drawn to determine the diagnostic efficiency of BALF GM assay for IPFI. The optimal cut-off point of BALF GM was determined using Youden index. RESULTS: BALF GM had an area under the curve (AUC) of 0.932 in diagnosing IPFI,with 87.5% sensitivity, 96.7% specificity, 87.5% positive predictive value,and 96.7% negative predictive value when the BALF GM value was set at 1.5 ng/mL as the optimal cut-off point. Higher BALF and serum GM values were found in the confirmed IPA group,followed by the clinical diagnosed group compared with the non-IPA group ( P<0.05). The threshold value was set at 0.5 ng/mL for serum GM and 1.5 ng/mL for bronchoalveolar lavage GM. Higher positive rates were found in the confirmed IPA group and the clinical diagnosed group compared with the non-IPA group ( P<0.05). Serum GM appeared to have higher false positives and false negative rates. CONCLUSION: BALF GM is a rapid and accurate indicator with high sensitivity and specificity for the early diagnosis of IPA.