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Changes in ocular lesions and demographic characteristics of HIV/AIDS patients in the Department of Ophthalmology of Peking Union Medical College Hospital in 18 years

Posting time:2022-12-02 02:55:10

Changes in ocular lesions and demographic characteristics of HIV/AIDS patients in the Department of Ophthalmology of Peking Union Medical College Hospital in 18 years

Professor Ye Junjie's team from Peking Union Medical College Hospital recently published a clinical study entitled "Temporal trends in ocular manifestations of HIV/AIDS patients in the past 18 years in a tertiary hospital in China" in Graefe's Archive for Clinical and Experimental Ophthalmology (IF 3.535). Research results, this study summarized the clinical data of human immunodeficiency virus (HIV) infected patients/acquired immunodeficiency syndrome (AIDS) patients who visited the ophthalmology department of our hospital from 2001 to 2018, and analyzed the ocular and systemic lesions over time. changing characteristics. AIDS is a fatal disease involving multiple systems of the whole body, and it is a public health problem of global concern. After HIV infection, the patient's CD4+ T lymphocyte count decreased progressively, and finally entered the AIDS stage. Combined antiretroviral therapy (cART) is an effective method for the treatment of HIV/AIDS. The widespread clinical application of cART in my country began in 2003, mainly due to the development of free treatment in the country. Eye-related lesions are one of the common complications in the onset of HIV/AIDS patients. Since 2001, the Department of Ophthalmology of Peking Union Medical College Hospital took the lead in conducting researches on eye lesions of HIV/AIDS patients in my country, and accumulated rich experience in clinical diagnosis and treatment. In order to understand the characteristics of the ocular and systemic conditions of HIV/AIDS patients over time, we conducted the following studies. A total of 264 HIV/AIDS patients (528 eyes) were included in this study from February 2001 to December 2018 in the ophthalmology department of our hospital (Fig. 1). All patients were required to complete the registration form when they visited the clinic, including the basic information of the patients, past eye Partial and systemic condition, infection route, CD4+T lymphocyte count, visual acuity, anterior segment and mydriatic fundus examination. According to the time of patient visit: 2001-2003, 2004-2006, 2007-2009, 2010-2012, 2013-2015, 2016-2018; according to the time of free cART treatment in my country: Pre-2003 group, Post-2003 group ; According to the fundus conditions, they were divided into: non-cytomegalovirus retinitis (CMVR) group, CMVR group, or non-human immunodeficiency virus retinopathy (HIVR) group, HIVR group. Figure 1. HIV/AIDS patients included in this study from 2001 to 2018. The results of this study showed that the average age of HIV/AIDS patients was 37.45±10.52 years old, including 197 males and 67 females, of which male patients accounted for 2010 -2012 (87.5%) was significantly higher than 2007-2009 (61.54%) (P<0.001). Types of infection: 43 HIV-infected patients, 193 AIDS patients, and 28 HIV/AIDS and syphilis co-infected patients. The proportion of HIV-infected patients in the Post-2003 group (12.81%) was lower than that in the Pre-2003 group (27.87%). P= 0.003), the proportion of HIV/AIDS and syphilis co-infected in the Post-2003 group (13.79%) was higher than that in the Pre-2003 group (0%) (P= 0.002). Transmission route: Blood transmission was the main way from 2001 to 2009, and sexual transmission was the main way from 2010 to 2018. The proportion of same-sex transmission in 2010-2012 (48.44%) was significantly higher than that in 2007-2009 (5.13%) (P<0.001). Occupation: 34 cases of professional and technical personnel, 18 cases of public officials, 5 cases of business personnel, 76 cases of service industry employees, 102 cases of manual laborers, and 29 cases of unemployed personnel. The proportion of service industry personnel in 2016-2018 was significantly higher than that in 2001-2003 ( 1.64%-66.67%), while the proportion of manual workers decreased significantly (86.89%-9.52%). Residence: 32 cases in Northeast China, 26 cases in East China, 106 cases in North China, 85 cases in Central China, 3 cases in South China, 5 cases in Southwest China, and 7 cases in Northwest China. , 0.04), the proportion of patients in Central China decreased (P < 0.001) (Table 1, 2). Table 1. Comparison of demographic characteristics of HIV/AIDS patients in different time periods Table 2. Comparison of demographic characteristics of HIV/AIDS patients in Pre-2003 group and Post-2003 group Systemic manifestations: Common symptoms included fever in 110 cases, rash in 31 cases, There were 30 cases of cough, 25 cases of dyspnea and 25 cases of diarrhea, and 13 cases of weight loss. The proportion of HIV/AIDS patients with systemic symptoms was significantly lower in the Post-2003 group (64.04%) than in the Pre-2003 group (81.87%) (P<0.001). Ocular manifestations: Visual acuity: 15 eyes with no light perception, 51 eyes with light perception to 0.05, 57 eyes with 0.06 to 0.3, 139 eyes with 0.4 to 0.8, 266 eyes with > 0.8; 103 cases of HIV/AIDS complicated with eye lesions (159 eyes), including 51 cases of CMVR (80 eyes), 51 cases of uveitis (77 eyes), 46 cases of HIVR (67 eyes), 26 cases of cataract (49 eyes), 4 cases of optic atrophy (6 eyes), corneal There were 3 cases (3 eyes) of lesions, of which the proportion of uveitis in the Post-2003 group (27.76%) was higher than that in the Pre-2003 group (13.51%) (P = 0.001). After 2003, there were 203 HIV/AIDS patients, According to whether or not CMVR was combined, they were divided into non-CMVR group (159 cases) and CMVR group (44 cases). The proportion of women in CMVR group (29.54%) was higher than that in non-CMVR group (15.72%) (P= 0.038). Whether combined with HIVR or not, they were divided into non-HIVR group (172 cases) and HIVR group (31 cases), and the proportion of HIVR group aged ≥ 45 years (48.39%) was higher than that of non-HIVR group (23.26%) (P=0.004) (table 3). Table 3. Comparison of ocular manifestations in HIV/AIDS patients at different time periods and between the Pre-2003 group and the Post-2003 group In summary, young and middle-aged men are susceptible to HIV; Homosexual transmission is increasing year by year; the proportion of AIDS patients is high, and the number of HIV/AIDS patients with syphilis infection is increasing year by year; after the implementation of free cART treatment in my country, the systemic symptoms of HIV/AIDS patients have decreased significantly; CMVR, uveitis and HIVR are HIV/AIDS The main ocular manifestations of the patients, the proportion of patients with CMVR and HIVR is stable, and the number of patients with uveitis is increasing year by year. Article citation: Di Y, Yu W, Ye J. Temporal trends in ocular manifestations of HIV/AIDS patients in the past 18 years in a tertiary hospital in China [published online ahead of print, 2022 Apr 23]. Graefes Arch Clin Exp Ophthalmol .Professor Ye Junjie commented that our team has taken the lead in carrying out basic and clinical research on eye lesions of HIV-infected AIDS patients in my country since 2001, and has accumulated a large number of eye lesions data and rich clinical experience. Recently, a clinical study entitled "Temporal trends in ocular manifestations of HIV/AIDS patients in the past 18 years in a tertiary hospital in China" was published in Graefe's Archive for Clinical and Experimental Ophthalmology. Change characteristics of ocular and systemic lesions in HIV/AIDS patients at different time periods. In this study, according to the implementation of free treatment for HIV/AIDS patients in my country, they were divided into 2 groups: before 2003 and after 2003; according to fundus lesions, they were divided into 4 groups (after 2003): non-CMVR group, CMVR group, non-HIVR group, HIVR group. The results show that since the Chinese government began to implement free treatment for HIV/AIDS patients in 2003, the systemic symptoms of HIV/AIDS patients have decreased significantly and the survival period has been prolonged. The central government's decision has effectively controlled blood transmission. At present, blood transfusion transmission in my country is basically blocked. At the same time, the results suggest that sexual transmission is the main mode of transmission at present, among which homosexual transmission is increasing year by year, and young and middle-aged men are susceptible to HIV. The results of this study show that cytomegalovirus retinitis and HIV retinopathy are still the main ocular complications of HIV/AIDS patients, but the number of eyes with uveitis is increasing year by year, mainly in patients with HIV/syphilis dual infection. In the study, HIV/AIDS patients with syphilis infection increased significantly from 0% (before 2003) to 13.79% (after 2003), which is related to the increase in the proportion of sexual transmission, especially the increase in the proportion of homosexual transmission. Therefore, it is crucial to strengthen publicity, improve people's awareness of self-protection, and enhance social responsibility. Let us work together to fight AIDS, and work together to achieve life first, end AIDS, and health equality. Finally, I would like to thank Professor Yu Weihong and Postdoctoral Di Yu for their contributions in the process of organizing the article data, data statistics, and article writing! 【Author information】The first author, Di Yu, is a 2019 doctoral student of Peking Union Medical College Hospital, and plans to enter the clinical postdoctoral station of Peking Union Medical College Hospital. During his doctoral studies, he published 11 SCI articles, 13 articles in Chinese core journals, participated in and completed 4 clinical trials and 2 basic animal experiments; participated in the compilation and compilation of 4 ophthalmology books; participated in many domestic and foreign conferences, gave special reports and Speech; During the study period, he won the postgraduate scholarship and the title of outstanding postgraduate every academic year, and was rated as the outstanding graduate of Beijing in 2022; participated in the first prize of writing in the Peking Union Medical College Hospital Science Contest, the best presentation award in the speech contest of Tsinghua Chang Gung Hospital, and the "Long World" The first prize of the "Mu Guangming" National Chinese Speech Contest, the third prize of the National Postgraduate Speech Contest; has passed the International Ophthalmologist (ICO) Step I Exam. The corresponding author, Junjie Ye, is a professor, chief physician, supervisor of postgraduate students, then deputy director of the Department of Ophthalmology (2005-2014), and deputy head of the Ophthalmic Immunology Group of the Ophthalmology Branch of the Chinese Medical Association (2014-2018). Won the Chinese Women Physician Association Wuzhou Women's Science and Technology Award, 5 scientific and technological progress awards (main participants), 6 national excellent paper awards, 2 outstanding scientific and technological writing awards, etc. Published 141 Chinese and English articles, 35 of which were included in SCI, edited 1 book, and participated in editing 21 books. He is currently the deputy director of the Uveitis Immunity Professional Committee of the Ophthalmology Branch of the Chinese Medical Doctor Association, the standing committee member of the Ophthalmology Disease Prevention and Control Branch of the Chinese Association for Geriatric Health Care Medicine, the advisory member of the Maculopathy Group of the Ophthalmology Branch of the Cross-Strait Medical and Health Exchange Association, and the Chinese Society of Microcirculation. Advisory member of the Circulation Professional Committee, Advisory Member of the Expert Committee of the Chinese Association of Women Physicians, etc. Currently, he is an editorial board member of the "Chinese Journal of Ophthalmology", "Chinese Journal of Experimental Ophthalmology", "Chinese Journal of Ophthalmology", "Chinese Journal of Ophthalmology", and "New Advances in Ophthalmology". . Text / Edited by Di Yu / Rotating Editor-in-Chief of Cao Miao / Editor-in-Chief of Chen Di / Producer of Zhao Chan / Chen Youxin

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