Objective To investigate the changes and distribution of opportunistic infections in AIDS patients during 6 months after the initiation of highly active antiretroviral therapy (HAART). Methods A retrospective and prospective study was carried out by using case report form, including the content such as subject number, the date of the HAART initiation, gender, age, treatment regimens, opportunistic infection status during 3 months before HAART, and during 2 weeks, week 2 to month 3 and 3-6 months of treatment, and the changes of CD4+ T lymphocyte counts at baseline, and during 3 and 6 months of treatment. Results Among 192 patients, 93 (48.44%) had fever, 39 (20.31%) diarrhea, and 46 (35.90%) tuberculosis (TB) during 3 months before HAART. CD4+ T lymphocyte count was 91/μl at baseline. During 2 weeks of treatment, 69 patients (35.90%) had fever, among whom 7 (3.65%) were newly diagnosed, 57 (29.69%) had respiratory system disease, and 56.1% had TB, among whom 3 were newly diagnosed or infected with TB. The incidences of oral thrush and herpes zoster were 12.5% and 14.6%. During week 2 and month 3 of treatment, the incidence rate of respiratory system symptom and oral thrush and herpes zoster were 2.08% and 1.56%, and new TB cases were not found. During 3-6 months of treatment, the cases of fever and respiratory system disease were found with a low incidence rate. After 6 months of treatment, CD4+ T lymphocyte count increased by 11l/μl. Conclusions Fever is the most common sign of AIDS patients. The incidence of fever decreases significantly as HAART continues (P<0.05), and it is closely correlated with whether a patient has a fever before treatment. The incidence of swallow difficulty and pain, TB, oral thrush, respiratory system disease and herpes zoster decreases significantly (P<0.05). The incidence of diarrhea decreases, but the difference is not significant (P>0.05). Perhaps, it is because that the incidence of diarrhea is correlated not only with the opportunistic infections but also with adverse reactions of drugs and non-specific inflammation.%目的 探讨对AIDS患者进行高效抗反转录病毒治疗6个月内机会性感染的变化和分布状况.方法 使用统一的调查表进行回顾性和前瞻性研究.调查表的内容涉及患者编号、性别、年龄、治疗开始时间、治疗方案、开始抗病毒治疗前3个月、治疗后2周内、2周～3个月和3～6个月出现机会性感染的情况及基线、治疗3个月和治疗6个月CD4+T淋巴细胞的变化等.结果 192例接受抗病毒治疗的患者中,治疗前3个月内曾出现发热93例(48.44％),腹泻39例(20.31％),患结核病46例(23.96％).治疗前CD4+T淋巴细胞平均值为91/μl.治疗后2周内发热69例(35.90％),新出现者7例(3.65％);呼吸系统疾病57例(29.69％);结核病发生率为56.1％,其中3例(1.56％)为新发现或新感染者;鹅口疮发生率为12.5％;带状疱疹发生率为14.6％.治疗2周～3个月呼吸系统疾病发生率为2.08％,鹅口疮和带状疱疹发生率为1.56％,结核病无新发病例出现.治疗3～6个月仍有发热及呼吸系统疾病病例出现,但发生率较低.治疗6个月后CD4T淋巴细胞平均上升了111/μl.结论 发热是AIDS期最容易出现的体征,随着抗病毒治疗时间的延长,发生率明显下降(P＜0.05),且发热的发生与治疗前是否曾经发热有很大的相关性.吞咽困难/吞咽疼痛、结核病、鹅口疮、呼吸系统疾病和带状疱疹的发生率也呈明显下降趋势(P＜0.05).腹泻发生率虽也有所下降,但差异无统计学意义(P＞0.05),可能腹泻的发生除了与机会性感染相关外,也与药物的不良反应和非特异性的炎症相关.
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