Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct 25;8(10):e75915.
doi: 10.1371/journal.pone.0075915. eCollection 2013.

Spectrums of opportunistic infections and malignancies in HIV-infected patients in tertiary care hospital, China

Jiang Xiao  1 , Guiju Gao, Yanmei Li, Wen Zhang, Yunfei Tian, Yingxiu Huang, Wenjing Su, Ning Han, Di Yang, Hongxin Zhao
Affiliations

Spectrums of opportunistic infections and malignancies in HIV-infected patients in tertiary care hospital, China

Jiang Xiao et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(1). doi:10.1371/annotation/bbbcd86d-200e-49d6-a3e3-aef3e083fab2. Huang, Yinxiu [corrected to Huang, Yingxiu]

Abstract

Background: HIV-related opportunistic infections (OIs) and malignancies continued to cause morbidity and mortality in Chinese HIV-infected individuals. The objective for this study is to elucidate the prevalence and spectrums of OIs and malignancies in HIV-infected patients in the Beijing Ditan Hospital.

Methods: The evaluation of the prevalence and spectrums of OIs and malignancies was conducted by using the clinical data of 834 HIV-infected patients admitted in the Beijing Ditan hospital from January 1, 2009, to November 30, 2012.

Results: The prevalence and spectrums of OIs and malignancies varied contingent on geographic region, transmission routes, and CD4 levels. We found that tuberculosis was most common OI and prevalence was 32.5%, followed by candidiasis(29.3%), Pneumocystis pneumonia(PCP)(22.4%), cytomegalovirus(CMV) infection(21.7%), other fungal infections(16.2%), mycobacterium avium complex(MAC)(11.3%), cryptococcosis(8.0%), progressive multifocal leukoencephalopathy(PML)(4.4%), Cerebral Toxoplasmosis(3.5%) and Penicillium marneffei infection(1.4%); while Lymphoma(2.9%), Kaposi's sarcoma(0.8%) and cervix carcinoma(0.3%) were emerged as common AIDS-defining malignancies. Pulmonary OI infections were the most prevalent morbidity and mortality in patients in the AIDS stage including pulmonary tuberculosis (26.6%) and PCP (22.4%). CMV infection(21.7%) was most common viral infection; Fungal OIs were one of most prevalent morbidity in patients in the AIDS stage, including oral candidiasis (29.3%), other fungal infection (16.2%), Cryptococcosis (8.0%) and Penicillium marneffei infection (1.4%). We found the low prevalence of AIDS-defining illnesses in central neural system in this study, including progressive multifocal leukoencephalopathy (4.4%), cerebral toxoplasmosis (3.5%), tuberculosis meningitis (3.2%), cryptococcal meningitis (2.4%) and CMV encephalitis (1.1%). In-hospital mortality rate was 4.3 per 100 person-years due to severe OIs, malignancies, and medical cost constraints.

Conclusions: The prevalence and spectrums of OIs, malignancies and co-infections were discussed in this study. It would help increase the awareness for physicians to make a diagnosis and empirical treatment sooner and plan good management strategies, especially in resource limited regions.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Study flow diagram.
Figure 2
Figure 2. Spectrum of OIs and Malignancies in HIV-infected Patients based on etiologic and empirical diagnosis in the Beijing Ditan Hospital from January 1, 2009 to November 30, 2012.
Note: PCP:pneumocystis pneumonia; CMV: cytomegalovirus; MAC: Mycobacterium avium complex; PML: progressive multifocal leukoencephalopathy.
Figure 3
Figure 3. Prevalence of OIs and Malignancies Related to Geographic Regions in the Study Subjects.
1.Tuberculosis; 2.Candidiasis; 3.PCP; 4.CMV infection; 5.Other fungal infection; 6.MAC; 7.Cryptococcosis; 8. PML; 9. Cerebral Toxoplasmosis; 10. Lymphoma; 11.Penicillium Marneffei infection; 12. Kaposi's Sarcoma.
Figure 4
Figure 4. The Prevalence of OIs and Malignancies Related to Transmission Routes in the Study Subjects.
1.Tuberculosis; 2.Candidiasis; 3.PCP; 4.CMV infection; 5.Other fungal infection; 6.MAC; 7.Cryptococcosis; 8. PML; 9. Cerebral Toxoplasmosis; 10. Lymphoma; 11.Penicillium Marneffei infection; 12. Kaposi's Sarcoma.
Figure 5
Figure 5. The Prevalence of OIs and Malignancies related to CD4 counts in study subjects.
1.Tuberculosis; 2.Candidiasis; 3.PCP; 4.CMV infection; 5.Other fungal infection; 6.MAC; 7.Cryptococcosis; 8. PML; 9. Cerebral Toxoplasmosis; 10. Lymphoma; 11.Penicillium Marneffei infection; 12. Kaposi's Sarcoma.
Figure 6
Figure 6. Distribution of CD4+T Counts and In-hospital deaths in the Study Subjects.
See this image and copyright information in PMC

References

    1. UNAIDS/WHO Working Group on HIV Global /AIDS and STI Surveillance. (2012) China’s epidemic & response, 2012 update. Available: <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.unaids.org.cn/en/index/index.asp"><underline>http://www.unaids.org.cn/en/index/index.asp</underline></ext-link>. .
    1. Zhang FJ, Pan J, Yu L, Wen Y, Zhao Y (2005) Current progress of China’s free ART program. Cell Res 15: 877–882. doi: 10.1038/sj.cr.7290362. PubMed: 16354563. - DOI - PubMed
    1. Zhang F, Haberer JE, Wang Y, Zhao Y, Ma Y et al. (2007) The Chinese free antiretroviral treatment program: challenges and responses. AIDS 21 Suppl 8: S143-S148. doi: 10.1097/01.aids.0000304710.10036.2b. PubMed: 18172383. - DOI - PubMed
    1. Chou IH (2004) China's new AIDS policy faces great wall of skepticism. Nat Med 10: 4. doi: 10.1038/nm0104-4a. PubMed: 14702606. - DOI - PubMed
    1. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents (2013) uidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the centers for disease control and prevention, the National Institutes of Health, and the HIV Medical Association of the Infectious Diseases Society of America. Available: <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf"><underline>http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf</underline></ext-link>. Accessed 2013 May 7.

Publication types