BACKGROUND AND AIM:The exploration of age-related clinical characteristics and prognosis of severe fever with thrombocytopenia syndrome (SFTS) has not been extensively addressed in current research. This study aimed to analyze the differences in clinical features and outcomes of SFTS patients across various age groups. METHODS:Patients were assigned to four groups: those aged ≤ 54 years, those aged 55-64 years, those aged 65-74 years, and those aged ≥ 75 years. Then, their clinical data were compared. RESULTS:A total of 253 patients diagnosed with SFTS were retrospectively included. Compared with patients aged < 65 years, patients aged ≥ 65 years had higher serum levels of laboratory parameters indicating liver, kidney, heart, and coagulation system injury, as well as a higher viral load. Moreover, the serum levels of procalcitonin, SAA, ferritin, IL-6, IL-10, and TNF-α were significantly higher, but the percentages and counts of CD3+ and CD3 + CD4 + lymphocytes were significantly lower in patients aged ≥ 65 years than in patients aged < 65 years. The cumulative survival rate of patients aged ≥ 65 years was also significantly lower than that of patients aged < 65 years. Univariate and multivariate logistic regression analyses identified that age ≥ 65 years was an independent risk factor for the prognosis of patients with SFTS. CONCLUSION:Age significantly influences the clinical features and prognosis of patients, and age ≥ 65 years is associated with adverse outcomes in patients with SFTS.

Pneumonia is common in patients with severe fever with thrombocytopenia syndrome (SFTS), and respiratory failure is one of its most severe complications. The aim of this study was to establish a nomogram for predicting respiratory failure development in SFTS patients with pneumonia. Data of demographics, comorbidities, clinical manifestations, laboratory parameters, complications, and outcomes of SFTS patients with pneumonia were collected. Independent predictors of respiratory failure development on multivariate logistic regression were used to construct the predictive model. Of the 167 SFTS patients with pneumonia we studied, 45 (26.9%) patients developed respiratory failure. Patients who developed respiratory failure had a higher incidence of invasive pulmonary aspergillosis, nosocomial infections, myocarditis, acute kidney injury (AKI) stage 2 or 3, rhabdomyolysis, shock, and systemic inflammatory response syndrome (SIRS). Among them, 35 patients died and all patients without respiratory failure survived. On multivariate regression analysis, neurological manifestations, nosocomial infections, AKI stage 2 or 3, SIRS, serum levels of albumin, and CKMB were proven to be independent predictors for respiratory failure development, which were adopted as parameters of the nomogram. The nomogram showed good calibration and discrimination, with an area under the receiver operating characteristic curve of 0.932 (95% CI 0.888-0.975). Decision curve analysis confirmed the clinical utility of the predictive model. Respiratory failure is associated with adverse outcomes including severe complications and death in SFTS patients with pneumonia. Clinicians could apply the nomogram to identify the high-risk pneumonic patients for developing respiratory failure.

Primary adrenal insufficiency (PAI) is a common endocrine complication in AIDS patients, but the diagnosis is often delayed due to the atypical clinic symptoms, which may result in a life-threatening adrenal crisis. In this report we present the clinical data of three patients with AIDS and PAI, summarizing the etiology, clinical characteristics, treatment and prognosis. All enrolled three patients were male, aged between 32 and 54 years. Their CD4+ T lymphocyte count (CD4 count) were 58 cells/µL, 378 cells/µL and 35 cells/µL respectively. Two patients had cytomegalovirus (CMV) infection and one had tuberculosis (TB), which were considered to be the main etiologies for PAI. The reported cases exhibited nonspecific clinical symptoms, including fatigue, weight loss, vomiting, diarrhea, anorexia, and fever. All three patients had skin and mucous membrane hyperpigmentation, and two experienced adrenal crisis characterized by intractable hypotension and hyponatremia. Laboratory results revealed low cortisol and higher adrenocorticotropic hormone (ACTH) in serum. All patients responded well to glucocorticoid replacement therapy. By follow-up, their CD4 counts increased steadily. In patients with AIDS, especially those with opportunistic infection such as CMV infection or TB, PAI should be considered when symptoms of glucocorticoid deficiency are present. Conversely, in AIDS patients diagnosed with PAI, potential underlying infections such as CMV or TB should be actively investigated.

Background Until recently, severe fever with thrombocytopenia syndrome (SFTS)-related disseminated intravascular coagulation (DIC) had not been elucidated. This study aimed to explore the clinical characteristics and outcomes of DIC in patients with SFTS. Methods Patients diagnosed with SFTS who were admitted to Zhongnan Hospital of Wuhan University from August 2016 to October 2023 were included. Patients’ demographics and clinical data were collected. According to the presence of DIC, they were assigned into the DIC and non-DIC groups. Independent risk factors for prognosis were identified by univariate and multivariate logistic regression analyses. Results A total of 246 consecutive patients diagnosed with SFTS were enrolled, including 216 (87.8%) patients in the non-DIC group and 30 (12.2%) patients in the DIC group. ALT, AST, ALP, GGT, LDH, creatinine, cystatin-C, amylase, lipase, CK, CK-MB, troponin I, BNP, PT, PTA, APTT, TT, FDP, D-dimer, CRP, procalcitonin, IL-6, SAA, ESR, ferritin levels, and viral load were significantly higher in patients with DIC. The cumulative survival rate of patients with DIC was significantly lower than that of patients without DIC. Furthermore, it is demonstrated that the presence of DIC was an independent risk factor for in-hospital mortality of patients with SFTS. Conclusion DIC is a potential complication and is associated with high mortality in patients with SFTS. Early recognition and timely management of this serious complication are important for patients with SFTS.

BACKGROUND:Neurosyphilis (NS) is experiencing a resurgence globally, particularly with higher incidence rates among people living with HIV (PLWH). However, due to the diversity of symptoms associated with NS, especially among PLWH, the diagnosis and treatment of NS still present certain challenges. METHODS:We retrospectively analyzed data from the clinical records of NS patients between December 2016 and December 2022 in Zhongnan Hospital of Wuhan University and The People's Hospital of Jianyang City. The clinical and laboratory data were collected among PLWH and HIV-negative patients. RESULTS:A total of 80 patients (53 PLWH and 27 HIV-negative patients) were included in the study. The median age of PLWH was 32 years (IQR 27-44 years), and 94% of participants were men. Among HIV-negative patients, the median age was 40 years (IQR 32-48 years), 81% were men. A total of 10 (19%) PLWH had a history of syphilis, whereas none of the HIV-negative patients had a history of syphilis. Visual impairment was the most common clinical symptom in PLWH (33%), whereas a decrease of muscle strength was the most common clinical symptom in HIV-negative patients (29%). No differences of laboratory features and outcome were found between these two groups. In both groups, cerebrospinal fluid white blood cell count, cerebrospinal fluid protein concentration and the proportion of participants with abnormal brain imaging were significantly higher in the symptomatic NS patients than that in the asymptomatic NS patients. CONCLUSION:Despite the similar outcome of NS in PLWH and HIV-negative populations, the primary symptoms still differ, highlighting the need for enhanced diagnostic methods, the ability to recognize NS early and provision of timely interventions.

BACKGROUND:Severe fever with thrombocytopenia syndrome (SFTS) is a life-threatening infectious disease triggered by a novel bunyavirus (SFTSV). The elderly population is vulnerable to infectious diseases. This study aimed to explore the clinical features and outcomes of elderly patients with SFTS and establish an effective prognostic nomogram for them. METHODS:Data on demographics, comorbidities, clinical manifestations, laboratory parameters, and outcomes of patients with SFTS were collected. Independent predictors for in-hospital mortality identified by multivariate logistic regression were used to construct the predictive model. RESULTS:253 patients with SFTS were retrospectively enrolled, including 142 (56.1%) elderly patients and 111 (43.9%) non-elderly patients. Compared with non-elderly patients, elderly patients had higher serum levels of laboratory parameters indicating liver, kidney, pancreas, heart, coagulation system injury, and higher viral load. The in-hospital mortality rate of elderly patients was significantly higher than that of non-elderly patients. The univariate and multivariate binary logistic regression analyses demonstrated that neurological manifestations, creatinine, CKMB, and prothrombin time were proven to be independent predictors for in-hospital mortality of elderly patients with SFTS, which were adopted as parameters of the nomogram. The nomogram showed a good calibration and discrimination, with an area under the receiver operating characteristic curve of 0.849 (95% CI 0.774-0.923). Decision curve analysis confirmed the clinical utility of the predictive model. CONCLUSIONS:Elderly patients are more susceptible to adverse outcomes, and the nomogram can help clinicians predict in-hospital mortality of elderly patients with SFTS, which may facilitate optimal therapeutic strategies to improve their prognosis.

People living with HIV (PLWH) are known to exhibit more severe or prolonged symptoms of mpox (formerly monkeypox). However, the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on PLWH with mpox has not been adequately described. We report a case of mpox in an AIDS patient who had recurrent symptoms due to SARS-CoV-2 infection. The patient presented with a low CD4+ lymphocyte count (CD4 count) without antiretroviral therapy (ART) and suffered from severe mpox. The ART was initiated 17 days after the diagnosis of mpox, and the patient's skin lesions began crusting after 1 week of ART. However, after a SARS-CoV-2 infection, the mpox flared up again. The patient presented with more severe symptoms than those during the initial bout and with rectal involvement. We speculate that SARS-CoV-2 infection might cause a recrudescence of mpox in AIDS patients, which requires further investigation.

Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis with a high fatality rate in China. Previous studies have reported that dysregulated inflammatory response is associated with disease pathogenesis and mortality in patients with SFTS. This investigation aimed to evaluate the prevalence and characteristics of systemic inflammatory response syndrome (SIRS), and its impact on prognosis. Methods Data on demographic characteristics, comorbid conditions, clinical manifestations, laboratory parameters, and survival time of patients with SFTS were collected. Patients were divided into the non-SIRS and SIRS groups according to the presence of SIRS, then their clinical data were compared. Results A total of 290 patients diagnosed with SFTS were retrospectively enrolled, including 126(43.4%) patients with SIRS. Patients in the non-survivor group had more prevalence of SIRS than patients in the survivor group ( P < 0.001), and SIRS (adjusted OR 2.885, 95% CI 1.226–6.786; P = 0.005) was shown as an independent risk factor for prognosis of patients with SFTS. Compared with patients without SIRS, patients with SIRS had lower WBC and neutrophils counts, and fibrinogen levels, but higher AST, LDH, amylase, lipase, CK, CK-MB, troponin I, APTT, thrombin time, D-dimer, CRP, IL-6, SAA levels, and viral load. The cumulative survival rate of patients with SIRS was significantly lower than that of patients without SIRS. Patients with SIRS also showed a higher incidence of bacterial or fungal infections than patients without SIRS. Conclusions SIRS is highly frequent in patients with SFTS, and it is associated with high mortality.

BackgroundThe burden of hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis coinfections remains disproportionately high among people living with HIV/AIDS. Hubei province is located in central China, where there are distinct regional characteristics of the distribution of people living with HIV/AIDS acquired via diverse transmission routes and the AIDS epidemic itself. ObjectiveWe aimed to estimate the magnitude of HBV, HCV, or syphilis coinfections among people living with HIV/AIDS with blood-borne transmission, which includes former paid blood donors, contaminated blood recipients, and intravenous drug users, as well as among people with sex-borne HIV transmission (including heterosexual people and men who have sex with men) and people with mother-to-child HIV transmission. MethodsFrom January 2010 to December 2020, people living with HIV/AIDS were tested for hepatitis B surface antigen (HBsAg), HCV antibodies, and syphilis-specific antibodies. The positive patients were further tested for HBV markers, HBV DNA, and HCV RNA, and received a rapid plasma reagin circle card test. All people living with HIV/AIDS were first divided into transmission groups (blood, sex, and mother-to-child); then, people with blood-borne HIV transmission were divided into former paid blood donors, contaminated blood recipients, and intravenous drug users, while people with sex-borne HIV transmission were divided into heterosexual people and men who have sex with men. ResultsAmong 6623 people living with HIV/AIDS, rates of chronic HCV infection were 80.3% (590/735) in former paid blood donors, 73.3% (247/337) in intravenous drug users, 57.1% (444/777) in contaminated blood recipients, 19.4% (21/108) in people with mother-to-child HIV transmission, 8.1% (240/2975) in heterosexual people, and 1.2% (21/1691) in men who have sex with men. Chronic HBV infection rates were similar among all people with blood-borne HIV transmission. However, compared to heterosexual people, the chronic HBV infection rate was greater in men who have sex with men (213/1691, 12.6% vs 308/2975, 10.4%; χ21=5.469; P=.02), although HBV exposure was less common (827/1691, 48.9% vs 1662/2975, 55.9%; χ21=20.982; P<.001). Interestingly, the combination of HBsAg and hepatitis B e antigen (HBeAg) was found in 11 patients with sex-borne HIV transmission, but in 0 people with blood-borne HIV transmission (11/196, 5.6% vs 0/521, 0%; χ21=29.695, P<.001). In people with sex-borne HIV transmission, the proportions of patients with a syphilis titer ≥1:16 and neurosyphilis were 8.6% (105/1227) and 7.8% (37/473), respectively, whereas these values were 0 in people with blood-borne HIV transmission. ConclusionsIn people living with HIV/AIDS, HCV transmission intensity was significantly associated with specific exposure modes of blood or sexual contact. The rate of chronic HBV infection among men who have sex with men was higher than in any other population. Attention should be paid to the high prevalence of neurosyphilis in people living with HIV/AIDS who contract HIV by sexual intercourse.

BackgroundThe reasons for gastrointestinal bleeding among patients with acquired immune deficiency syndrome (AIDS) were complex. Here we present an unusual case of life-threatening gastrointestinal bleeding caused by a cytomegalovirus-induced duodenal ulcer in an AIDS patient.Case presentationA 31-year-old male with AIDS was admitted on July 18, 2023, complaining of abdominal pain for 38 days and intermittent hematochezia for 12 days. During his hospitalization, gastrointestinal endoscopy attributed gastrointestinal bleeding to a giant duodenal ulcer. Furthermore, cytomegalovirus(CMV) infection was confirmed as the reason for the ulcer through metagenomic next-generation sequencing (mNGs), hematoxylin-eosin(HE) staining, and immunohistochemistry (IHC) staining for the biopsy tissue. The patient’s gastrointestinal bleeding was stopped by interventional embolization. Following a 4-week course of anti-CMV treatment, the giant duodenal ulcer was cured.ConclusionsFor AIDS patients with gastrointestinal bleeding, the CMV-induced gastrointestinal ulcer should be considered. Comprehensive mothods (mNGs, HE staining and IHC staining for biopsy tissue) were benefit for confirmed diagnosis. Beside anti-CMV treatment, the interventional embolization is a choice for hemostasis.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis caused by a novel bunyavirus. Until recently, rhabdomyolysis in SFTS was not elucidated. The objective of this study was to investigate the prevalence and clinical characteristics of rhabdomyolysis and its association with AKI and prognosis in patients with SFTS. A total of 231 consecutive patients diagnosed with SFTS were enrolled, including 144 (62.3%) patients in the no rhabdomyolysis group and 87 (37.7%) patients in the rhabdomyolysis group. Clinical characteristics and laboratory parameters of SFTS patients were compared between the no rhabdomyolysis and rhabdomyolysis groups. Patients with rhabdomyolysis had more frequency of confusion, cough, sputum, chest distress, abdominal pain, petechia and ecchymosis, headache, myalgia, and myasthenia than those without rhabdomyolysis. Compared with patients in the no rhabdomyolysis group, patients in the rhabdomyolysis group had higher serum levels of laboratory parameters referring to liver, kidney, pancreas, heart, coagulation system injury, and higher viral load. The cumulative survival rate of patients with rhabdomyolysis was significantly lower than that of patients without rhabdomyolysis. Furthermore, univariate and multivariate binary logistic regression analyses demonstrated that rhabdomyolysis was an independent predictor for acute kidney injury and mortality in patients with SFTS. Rhabdomyolysis may be an important contributing factor to adverse outcomes and its effects on mortality may be mediated by acute kidney injury in SFTS. The early detection and effective intervention of rhabdomyolysis may decrease the mortality of patients with SFTS.

BackgroundAntiretroviral therapy (ART) initiation before pregnancy was reported to have an increased risk of adverse pregnancy outcomes (APOs) than ART initiation during pregnancy. However, the risks of APOs associated with different ART regimens initiated before or during pregnancy remain unknown.MethodsPregnant women living with HIV (PWLHIV) from Hubei Province, China, were retrospectively enrolled between January 1, 2004, and December 31, 2021. The trends of ART initiation time and application of different ART regimens were evaluated over time, separately. Using no ART exposure before and during pregnancy as control, the risks of APOs associated with protease inhibitor (PI) based regimens and non-nucleoside reverse transcriptase inhibitors (NNRTIs) based regimens initiated before pregnancy were analyzed; and the risks of APOs associated with PI-based regimens, NNRTIs based regimens and zidovudine (AZT) monotherapy initiated during pregnancy were analyzed. APOs, including low birthweight (LBW), stillbirth, preterm birth (PTB) and early miscarriage, were reviewed.ResultsAmong 781 PWLHIV including 1,010 pregnancies, 522 pregnancies (51.7%) were exposed to ART before or during pregnancy. Of them, the proportion of ART initiation before pregnancy per year increased from around 20% in the early period to more than 60% after 2019. Efavirenz (EFV)-nucleoside reverse transcriptase inhibitors (NRTIs) (32.2%), LPV/r-NRTIs (31.2%), and nevirapine (NVP)-NRTIs (27.4%) were the most commonly used regimens, and the proportion of LPV/r-NRTIs used per year has increased to around 50.0% in recent years. LPV/r-NRTIs was associated with higher risks of LBW whether initiated before pregnancy [adjusted OR (aOR) = 2.59, 95%CI 1.04–6.45, p = 0.041] or during pregnancy (aOR = 2.19, 95%CI 1.03–4.67, p = 0.041), compared with no exposure to ART before and during pregnancy. However, no matter initiated before or during pregnancy, LPV/r-NRTIs had no significantly increased risks of stillbirth, PTB and early miscarriage, and EFV /NVP-NRTIs and AZT monotherapy had no significantly increased risks of LBW, stillbirth, PTB and early miscarriage when compared with no exposure to ART before and during pregnancy.ConclusionOur data suggests that LPV/r-NRTIs has been widely used among PWLHIV in recent years. However, the potential risk of LBW should be continuously monitored among PWLHIV whether LPV/r-NRTIs is initiated before or during pregnancy.

Objective:To investigate the birth weight (BW) of infants born to pregnant women living with human immunodeficiency virus (HIV) and its associated factors, and to provide more evidence for the prevention of mother-to-child transmission (PMTCT) in China.Methods:This study was a retrospective cohort study. Between January 2004 and December 2021, pregnant women living with HIV and their infants in Hubei Province were recruited and followed up, and clinical data were collected through hospital medical records and HIV/acquired immunodeficiency syndrome comprehensive response information management system. The multivariable linear regression was performed on the collected data to investigate associated influencing factors of BW.Results:In total, 531 pregnant women living with HIV (581 pregnancies) and 581 infants were enrolled. Of the 581 infants, 36 were HIV-positive, with a PMTCT rate of 6.2%. The mean BW of the infants was (3 075.0±470.2) gram. Protease inhibitor (PI) based-anti-retroviral therapy (ART) ( β=-0.1, 95% confidence interval ( CI)-188.2 to -37.1, P=0.004), ART in the first trimester( β=-0.1, 95% CI -201.9 to -65.5, P<0.001), infant HIV infection ( β=-0.1, 95% CI -310.4 to -68.2, P=0.002), hepatitis C virus infection ( β=0.1, 95% CI 71.2 to 410.4, P=0.005) and gestational age ( β=0.6, 95% CI 155.9 to 191.5, P<0.001) were associated with decreased BW. Conclusions:While improving the effectiveness of PMTCT for HIV, more attention should be paid to pregnant women who received ART in the first trimester and PI-based ART for preventing lower BW and improving maternal and infantile health.

BackgroundHBV coinfection is frequent in people living with HIV (PLWH) and is the leading cause of hepatocellular carcinoma (HCC). While risk prediction methods for HCC in patients with HBV monoinfection have been proposed, suitable biomarkers for early diagnosis of HCC in PLWH remain uncommon.MethodsLiquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to examine serum protein alterations in HCC and non-HCC patients with HIV and HBV co-infection. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Disease Ontology (DO) enrichment analysis were performed on the differentially expressed proteins (DEPs). The risk prediction model was created using five-cross-validation and LASSO regression to filter core DEPs.ResultsA total of 124 DEPs were discovered, with 95 proteins up-regulated and 29 proteins down-regulated. Extracellular matrix organization and membrane component were the DEPs that were most abundant in the categories of biological processes (BP) and cellular components (CC). Proteoglycans in cancer were one of the top three DEPs primarily enriched in the KEGG pathway, and 60.0% of DEPs were linked to various neoplasms in terms of DO enrichment. Eleven proteins, including GAPR1, PLTP, CLASP2, IGHV1-69D, IGLV5-45, A2M, VNN1, KLK11, ANPEP, DPP4 and HYI, were chosen as the core DEPs, and a nomogram was created to predict HCC risk.ConclusionIn HIV/HBV patients with HCC, several differential proteins can be detected in plasma by mass spectrometry, which can be used as screening markers for early diagnosis and risk prediction of HCC. Monitoring protease expression differences can help in the diagnosis and prognosis of HCC.

Background:Currently the responses of peripheral cytokine-secreting cells in the natural course of human immunodeficiency virus (HIV) and tuberculosis (TB) co-infection haven't been fully elucidated.Methods:The function of peripheral proinflammatory, regulatory and cytotoxic cytokine-secreting cells were investigated by direct intracellular cytokine staining (ICS) and flow cytometry, additionally, the absolute numbers of different cytokine-secreting cells were measured among patients with HIV/TB co-infection (HT group), and compared them with the healthy controls (HC group), patients with TB (TB group) and patients with HIV infection (HIV group). After one week's anti-TB treatment, the changes of the percentages of cytokine-secreting cells were further evaluated in TB and HT groups.Results:Totally 26 individuals in the HC group, 51 in the TB group, 26 in the HIV group and 29 in the HT group were enrolled. The HT. HT group exhibited significantly lower absolute numbers of IFN-γ+CD4+, IFN-γ+CD8+, TNF-α+CD4+, IL17A+CD4+ T cells and TNF-α+CD14+ monocytes than the TB and HIV groups. Compared with the TB group, the percentages of CD8+ T cells secreting IFN-γ and perforin (p=0.010; p=0.043) were significantly lower among the HT group. Compared with the HIV group, the percentages of CD4+, CD8+ T cells and CD14+ monocytes secreting TNF-α (p=0.013; p=0.001; p<0.001) were significantly decreased, and the percentage of CD8+ T cells secreting IL-17A (p=0.015) was significantly increased among the HT group. Both the percentages of CD4+ T cells secreting TGF-β (p<0.001; p=0.001), and CD4+ and CD8+ T cells secreting granzyme A (all p<0.001), were significantly higher among the HT group than among the TB group and HIV group. After one week's anti-TB treatment, an increased percentage of CD4+ T cells secreting TNF-α (p=0.003) was found in the TB group, and an increased percentage of CD8+ T cells secreting TNF-α (p=0.029) was found in the HT group.Conclusion:Significantly different functional profiles of peripheral proinflammatory, regulatory, and cytotoxic cytokine-secreting cells were observed in the natural course of HIV/TB co-infection compared to TB and HIV infection alone, even though the absolute numbers of those cells were significantly lower in HIV/TB co-infection. TNF-α-secreting CD8+ T cells may be a more sensitive marker for early evaluation of anti-TB treatment efficacy in patients with HIV/TB co-infection.

Background and aimThe increased pancreatic enzymes have recently been reported in patients with severe fever with thrombocytopenia syndrome (SFTS). However, its significance has not been elucidated clearly. The aim of this study was to explore the prevalence, clinical characteristics of elevated pancreatic enzymes (amylase and lipase) and its association with AP in patients with SFTS.MethodsData of demographics, comorbid conditions, clinical symptoms, laboratory parameters and survival time of patients with SFTS were collected. Patients were assigned into the non-AP and AP groups according to the diagnostic criteria of AP. Patients in the non-AP group were divided into the normal (3×ULN) groups according to the serum amylase and lipase levels, and then their clinical data were compared.ResultsA total of 284 patients diagnosed with SFTS were retrospectively enrolled, including 248 patients in the non-AP group and 36 patients in the AP group. Patients in the non-AP group were composed of 48, 116 and 84 patients in the normal, EPE and HPE groups, respectively. Compared with patients in the normal and EPE groups, patients in the HPE group had higher serum levels of laboratory parameters referring to liver, kidney, heart and coagulation system injury, as well as higher viral load. The cumulative survival rate of patients in the HPE group was significantly lower than that of patients in the normal group. In addition, patients in the AP group also had higher serum levels of laboratory variables reflecting liver, heart, coagulation dysfunction and viral load than patients in the HPE group. The cumulative survival rate of patients in the AP group was significantly lower than that of patients in the HPE group.ConclusionThe increased pancreatic enzymes are very common in patients with SFTS, but they are not always associated with AP. Though AP accounts for the majority of deaths for patients with elevated pancreatic enzymes, patients with pancreatic enzymes >3×ULN except for AP also have a high in-hospital mortality rate.

Oral ulcers are often neglected in patients with AIDS. However, giant oral ulcers are uncommon and are usually suspected to be malignant lesions. Our study presents a case of giant ulcers in an AIDS patient that were initially suspected to be oral cancer. To assist with diagnosis, conventional microbiological tests, metagenomic next-generation sequencing, and a pathological examination were conducted on oral lesion biopsy specimens. The case was finally confirmed via hematoxylin-eosin staining and immunohistochemical staining to be a cytomegalovirus infection.

肠炎沙门菌(Salmonella Enteritidis,SE)感染以消化道症状为主要表现,随着卫生条件改善其发病率降低.在HIV感染者中,SE感染后起病隐匿,临床表现多样且易进展为肠出血、肠穿孔或败血症等.文献报道HIV感染者合并SE感染较少,尤其是医院内感染更为罕见.为引起对SE的重视和预防SE相关院内感染,现报道艾滋病患者院内感染SE1例.

Hepatic tuberculosis (TB) is a rare type of extrapulmonary TB. Due to the nonspecific clinical symptoms and imaging manifestations, hepatic TB with human immunodeficiency virus (HIV) infection is easy to be misdiagnosed. We report a case of hepatic TB with acquired immune deficiency syndrome (AIDS), which was initially misdiagnosed as general bacterial liver abscess even after the patient received needle biopsy. In subsequent process, pathogenic tests using washing solution of punctured liver tissue sample were proved feasible, convenient, and specific for pathogenic diagnosis in resource-limited areas of China. For liver abscess in patients with HIV, the pathogens are more complex than HIV negative patients. Some uncommon pathogens, such as TB and fungi, should also be taken into consideration. For the hepatic TB without abscess formation, pathogenic test using washing solution of punctured liver tissue sample should be attached importance.

Electrolytes play a vital role in myocardial electrophysiological activities in the human body. Electrolyte disturbances can affect depolarisation and repolarisation of myocardial cells and thus result in arrhythmia. The most common electrolyte disturbance among hospitalised patients is hyponatraemia. We report on a case of an acquired immune deficiency syndrome patient with decompensated cirrhosis, who developed sinus arrest from hyponatraemia. The electrocardiogram manifestations at different sodium concentrations were also recorded in subsequent therapeutic processes.