Lymphocyte and its CD4+ and CD8+ subgroup changes after paraquat poisoning.

OBJECTIVE: Paraquat (PQ) poisoning is a significant cause of mortality and morbidity in developing countries. Poor prognostic outcomes have been attributed to the herbicide's toxicity and the lack of effective treatments. Our study aims to investigate the changes in lymphocyte count in both patients who survived and died from PQ poisoning and explore the prognostic value. METHOD: This is a retrospective case serials observational study. Adult patients admitted with acute PQ poisoning. The notes of 1000 patients who presented with acute PQ poisoning were reviewed. One hundred thirty patients having the T lymphocyte met the inclusion criteria and were grouped into those that survived the poisoning (95) and non-survivors (35). RESULTS: On admission, non-survivors had a higher ingestion volume of PQ and urine PQ concentration as well as higher severity indices (Acute Physiology and Chronic Health Evaluation 2, Sequential Organ Failure Assessment, and Poisoning Severity Score). Patients in the survival group had a higher dosage of immunosuppressant and a longer hospital stay. Leukocytes, especially neutrophils, were higher among non-survivors; however, the converse was found with lymphocytes. T lymphocyte (CD3) count was consistently higher among survivors as well as the subgroups CD4+ and CD8+. No differences in the ratio of CD4/CD8 were found between the groups. CONCLUSION: Our study has shown that changes in lymphocyte count as its subgroups could indicate a host's immune status and lymphocytes play an important role as a surrogate marker of host immunity, which could be a useful prognostic tool in the assessment of this disease.

Characteristics and abnormal rate of electrocardiogram in patients with human immunodeficiency virus/acquired immunodeficiency syndrome / 中华传染病杂志

Objective@#To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients.@*Methods@#The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved. The abnormality rates and characteristics of ECG were compared between the two groups. CD4+ T lymphocyte counts, CD8+ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/AIDS patients. The comparison between two groups was conducted by chi-square test. Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients.@*Results@#There were 611 cases (54.02%) out of 1 131 HIV/AIDS patients with abnormal ECG. The common abnormal ECG types were sinus tachycardia 239 cases (39.12%), sinus rhythm with ST-T changes 115 cases (18.82%) and sinus bradycardia 55 cases (9.00%). There were 1 958 cases (34.83%) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG. The common ECG abnormality types were sinus bradycardia 633 cases (32.33%), sinus rhythm with ST-T changes 463 cases (23.65%) and sinus arrhythmia 256 cases (13.07%). The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/AIDS subjects (χ2=140.39, P<0.01). The abnormal rates of ECG in HIV/AIDS patients <50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group, and the differences were statistically significant (χ2=111.92 and 52.12, respectively, both P<0.01). Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with non-HIV/AIDS individuals (odds ratio (OR)=2.27, 95% confidence interval (CI) 2.00-2.60, P<0.01). The risk of ECG abnormality increased in patients aged ≥50 years(OR=1.60, 95%CI 1.45-1.77, P<0.01). The ECG abnormal distribution patterns were significantly different between different levels of CD4+ T lymphocyte counts, CD8+ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (χ2= 12.92, 10.99 and 16.48, respectively, all P<0.05 ). The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR=1.50, 95%CI 1.15-1.96, P<0.01). When CD8+ T lymphocyte counts ≥500/μL, the risk of ECG abnormalities reduced (OR=0.75, 95%CI 0.58-0.96, P<0.01).@*Conclusions@#The abnormal rate of ECG in patients with HIV/AIDS is high. The sinus tachycardia and sinus rhythm with ST-T segment changes are common. The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8+ T lymphocyte counts ≥500/μL. Type distribution of ECG abnormalities is associated with cellular immune status of patients.

Characteristics and abnormal rate of electrocardiogram in patients with human immunodeficiency virus/acquired immunodeficiency syndrome / 中华传染病杂志

Objective To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS),and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients.Methods The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved.The abnormality rates and characteristics of ECG were compared between the two groups.CD4 + T lymphocyte counts,CD8+ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/ AIDS patients.The comparison between two groups was conducted by chi-square test.Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients.Results There were 611 cases (54.02％) out of 1 131 HIV/AIDS patients with abnormal ECG.The common abnormal ECG types were sinus tachycardia 239 cases (39.12％),sinus rhythm with ST-T changes 115 cases (18.82％) and sinus bradycardia 55 cases (9.00％).There were 1 958 cases (34.83％) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG.The common ECG abnormality types were sinus bradycardia 633 cases (32.33％),sinus rhythm with ST-T changes 463 cases (23.65％) and sinus arrhythmia 256 cases (13.07％).The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/ AIDS subjects (x2 =140.39,P ＜ 0.01).The abnormal rates of ECG in HIV/AIDS patients ＜ 50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group,and the differences were statistically significant (x2 =111.92 and 52.12,respectively,both P ＜ 0.01).Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with nonHIV/AIDS individuals (odds ratio (OR) =2.27,95％ confidence interval (CI) 2.00-2.60,P ＜ 0.01).The risk of ECG abnormality increased in patients aged ≥ 50 years (OR =1.60,95％ CI 1.45-1.77,P ＜ 0.01).The ECG abnormal distribution patterns were significantly different between different levels of CD4+ T lymphocyte counts,CD8+ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (x2 =12.92,10.99 and 16.48,respectively,all P ＜0.05).The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR =1.50,95％ CI 1.15-1.96,P ＜ 0.01).When C D8+ T lymphocyte counts ≥ 500/pL,the risk of ECG abnormalities reduced (OR =0.75,95％ CI 0.58-0.96,P ＜ 0.01).Conclusions The abnormal rate of ECG in patients with HIV/AIDS is high.The sinus tachycardia and sinus rhythm with ST-T segment changes are common.The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8+ T lymphocyte counts ≥ 500/μL.Type distribution of ECG abnormalities is associated with cellular immune status of patients.