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已发表论文
中国东部一家三级医疗中心住院 HIV 患者的共病聚类及免疫特征：一项回顾性分析
Authors Wan Z, Wang K, He L, Zhu X, Huang Y, Zhu B
Received 16 May 2025
Accepted for publication 15 August 2025
Published 15 September 2025 Volume 2025:18 Pages 4931—4940
DOI https://doi.org/10.2147/IDR.S538627
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Yan Li
Zhikai Wan,1 Kun Wang,2 Lingling He,1,3 Xueling Zhu,1 Ying Huang,1 Biao Zhu1
1The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, China-Singapore Belt and Road Joint Laboratory on Infection Research and Drug Development, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China; 2Department of Radiation Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Infectious Diseases, Zhuji People’s Hospital, Shaoxing, People’s Republic of China
Correspondence: Biao Zhu, The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, China-Singapore Belt and Road joint Laboratory on Infection Research and Drug Development, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, 310003, People’s Republic of China, Email zhubiao1207@zju.edu.cn
Background: Antiretroviral therapy (ART) has shifted hospitalization causes in people with HIV (PWH) from AIDS-related to non-AIDS-related events. Data on comorbidity profiles and clinical characteristics of hospitalized PWH remain limited. Therefore, this study analyzes comorbidities and clinical characteristics of PWH in eastern China to understand the regional burden of comorbidities and inform clinical practice and regional hospital management.
Methods: This retrospective study included 593 hospitalized PWH. Demographic, clinical, and laboratory data, along with HIV-related medical history, were extracted from medical records. Diagnoses of comorbidities were based on established criteria. Clinical characteristics were compared across comorbidity groups.
Results: Among 593 participants, comorbidities were categorized into three groups: Non-AIDS-Defining Diseases (NADs, n=241), Opportunistic Infections (OI, n=204), and Malignancies (n=111). PWH with malignancies were significantly older (median age 58 years) than those with OI (43 years, p=0.001) or NADs (42 years, p=0.001). Patients with OIs had a significantly shorter duration since HIV diagnosis and ART initiation compared with the NADs and malignancy groups. Immunological analysis showed that the NADs group had higher median CD4+ T cell counts [413.5 (234– 584) cells/μL] and CD4/CD8 ratios [0.75 (0.41– 1.18)] compared with the OI and malignancy groups. AIDS-Defining Malignancies (ADMs) cases had significantly lower CD4+ T cell counts than Non-AIDS-Defining Malignancies (NADMs) cases [134.5 (97– 313.75) vs 306 (200.25– 503.00) cells/μL, p=0.002]. Multivariate logistic regression analysis established that a CD4/CD8 ratio below 0.5 independently associated with ADMs [adjusted OR 3.47 (95% CI 1.37– 8.77), P=0.004].
Conclusion: NADs have emerged as the leading cause of hospitalization among PWH. For PWH who receive stable ART, remain at risk for NADs, warranting regular screening to prevent advanced disease. Routine monitoring of CD4+ T cell counts and CD4:CD8 ratios may facilitate improved cancer and OI screening strategies for individuals with persistently low ratios of CD4/CD8 or ART-naïve.
Keywords: human immunodeficiency virus, comorbidities, malignancies
1The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, China-Singapore Belt and Road Joint Laboratory on Infection Research and Drug Development, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China; 2Department of Radiation Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Infectious Diseases, Zhuji People’s Hospital, Shaoxing, People’s Republic of China
Correspondence: Biao Zhu, The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, China-Singapore Belt and Road joint Laboratory on Infection Research and Drug Development, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, 310003, People’s Republic of China, Email zhubiao1207@zju.edu.cn
Background: Antiretroviral therapy (ART) has shifted hospitalization causes in people with HIV (PWH) from AIDS-related to non-AIDS-related events. Data on comorbidity profiles and clinical characteristics of hospitalized PWH remain limited. Therefore, this study analyzes comorbidities and clinical characteristics of PWH in eastern China to understand the regional burden of comorbidities and inform clinical practice and regional hospital management.
Methods: This retrospective study included 593 hospitalized PWH. Demographic, clinical, and laboratory data, along with HIV-related medical history, were extracted from medical records. Diagnoses of comorbidities were based on established criteria. Clinical characteristics were compared across comorbidity groups.
Results: Among 593 participants, comorbidities were categorized into three groups: Non-AIDS-Defining Diseases (NADs, n=241), Opportunistic Infections (OI, n=204), and Malignancies (n=111). PWH with malignancies were significantly older (median age 58 years) than those with OI (43 years, p=0.001) or NADs (42 years, p=0.001). Patients with OIs had a significantly shorter duration since HIV diagnosis and ART initiation compared with the NADs and malignancy groups. Immunological analysis showed that the NADs group had higher median CD4+ T cell counts [413.5 (234– 584) cells/μL] and CD4/CD8 ratios [0.75 (0.41– 1.18)] compared with the OI and malignancy groups. AIDS-Defining Malignancies (ADMs) cases had significantly lower CD4+ T cell counts than Non-AIDS-Defining Malignancies (NADMs) cases [134.5 (97– 313.75) vs 306 (200.25– 503.00) cells/μL, p=0.002]. Multivariate logistic regression analysis established that a CD4/CD8 ratio below 0.5 independently associated with ADMs [adjusted OR 3.47 (95% CI 1.37– 8.77), P=0.004].
Conclusion: NADs have emerged as the leading cause of hospitalization among PWH. For PWH who receive stable ART, remain at risk for NADs, warranting regular screening to prevent advanced disease. Routine monitoring of CD4+ T cell counts and CD4:CD8 ratios may facilitate improved cancer and OI screening strategies for individuals with persistently low ratios of CD4/CD8 or ART-naïve.
Keywords: human immunodeficiency virus, comorbidities, malignancies