title: Spectrums of opportunistic infections and malignancies in HIV-infected patients in tertiary care hospital, China.
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.
authors.affiliation: Center for Infectious Diseases, Ditan Hospital, Capital Medical University, Beijing, the People's Republic of China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Xiao
authors.forename: Guiju
authors.initials: G
authors.lastname: Gao
authors.forename: Yanmei
authors.initials: Y
authors.lastname: Li
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Tian
authors.forename: Yingxiu
authors.initials: Y
authors.lastname: Huang
authors.forename: Yinxiu
authors.initials: Y
authors.lastname: Huang
authors.forename: Wenjing
authors.initials: W
authors.lastname: Su
authors.forename: Ning
authors.initials: N
authors.lastname: Han
authors.forename: Di
authors.initials: D
authors.lastname: Yang
authors.forename: Hongxin
authors.initials: H
authors.lastname: Zhao
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000635:transmission; D000328:Adult; D018791:CD4 Lymphocyte Count; D002681:China; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000150:complications*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D062606:Tertiary Care Centers