Objective To investigate the diagnostic value of brain magnetic resonance imaging in detecting central nervous system diseases among AIDS patients of different levels of T cells. Methods Total of 164 AIDS patients who did not receive antiviral treatment were divided into 2 groups according to their baseline CD4+ T cell counts. Group A had CD4+ T cell below or equal to 50 cells/μl(n = 81) and group B had CD4+ T cells over 50 cells/μl(n = 83). All patients underwent brain MRI scan. Imaging analysis and the prevalence of the central nervous system disorders were compared between two groups. Results Among them 48 cases were found of abnormal brain MRI, group A was higher than group B(35.8% vs. 22.9%) although without statistical significance(P = 0.065). Altogether 48 cases were diagnosed as AIDS related central nervous system disorders based on clinical symptoms, signs and laboratory findings. The prevalence of CNS disorders was higher in group A than in group B(41.9% vs. 16.8%) with statistical significance(P < 0.01). Conclusions The patients with CD4+ T cell count less than or equal to 50 cells/μl had high prevalence of CNS diseases. Brain MRI plays an important role in the diagnosis and differentiation of CNS diseases in advanced AIDS patients. This study suggests patients with low CD4+ T cell count(≤ 50/μl) should routinely undergo MRI examination.
Fang ZhaoLi-qing SunYi-mei TianLiu-mei XuPu-xuan LuXian TangYing-xia LiuHui Wang
Objectives To investigate the clinical features of tuberculosis(TB)-associated immune reconstitution inflammatory syndrome(TB-IRIS) in patients co-infected with HIV/TB or latent infection during highly active antiretroviral therapy(HAART).Methods HIV-infected patients treated in the Third People's Hospital of Shenzhen, China between March 2012 and March 2013 were recruited, and divided into 3 groups: 1) HIV/TB co-infection group(n = 50), 2) HIV/MTB latent infection group(n = 50), and 3) HIV infection group(n = 50), with 12-month follow-up. Patients in the HIV/TB co-infection group were treated with HAART 2 weeks after TB therapy. Patients were assessed at different time-points.Results The incidence and mortality rates of TB-IRIS were 40% and 10% in the HIV/TB co-infected patients, and 2%(and no mortality) in the HIV/MTB group. The HIV infected group did not display TB-IRIS or death. About 95% HIV/TB co-infected patients were 20-39 years old when TB-IRIS occurred, and 65% of the patients developed TB-IRIS 2 weeks after HAART. For the co-infection group, those with TB-IRIS(20/20, 100%) had fever, with a significantly higher incidence than those who did not develop TB-IRIS(6.7%, 2/30, P < 0.05). The patients with TB-IRIS in co-infection group displayed markedly higher clinical biochemical markers, acute phase reactants, increased CD4+ cell counts, and 2 log10-decreases of HIV RNA loads, compared with the patients not presenting with TB-IRIS(P < 0.05). Conclusion HIV/TB co-infected patients presented with a high-risk of developing TB-IRIS during HAART treatment. Early diagnosis and treatment could decrease mortality rates in TB-IRIS.
Yang ZhouHui WangSha-xi LiGui-lin YangYing-xia Liu
