ABSTRACT
Objective To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS),and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients.Methods The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved.The abnormality rates and characteristics of ECG were compared between the two groups.CD4 + T lymphocyte counts,CD8+ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/ AIDS patients.The comparison between two groups was conducted by chi-square test.Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients.Results There were 611 cases (54.02％) out of 1 131 HIV/AIDS patients with abnormal ECG.The common abnormal ECG types were sinus tachycardia 239 cases (39.12％),sinus rhythm with ST-T changes 115 cases (18.82％) and sinus bradycardia 55 cases (9.00％).There were 1 958 cases (34.83％) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG.The common ECG abnormality types were sinus bradycardia 633 cases (32.33％),sinus rhythm with ST-T changes 463 cases (23.65％) and sinus arrhythmia 256 cases (13.07％).The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/ AIDS subjects (x2 =140.39,P ＜ 0.01).The abnormal rates of ECG in HIV/AIDS patients ＜ 50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group,and the differences were statistically significant (x2 =111.92 and 52.12,respectively,both P ＜ 0.01).Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with nonHIV/AIDS individuals (odds ratio (OR) =2.27,95％ confidence interval (CI) 2.00-2.60,P ＜ 0.01).The risk of ECG abnormality increased in patients aged ≥ 50 years (OR =1.60,95％ CI 1.45-1.77,P ＜ 0.01).The ECG abnormal distribution patterns were significantly different between different levels of CD4+ T lymphocyte counts,CD8+ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (x2 =12.92,10.99 and 16.48,respectively,all P ＜0.05).The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR =1.50,95％ CI 1.15-1.96,P ＜ 0.01).When C D8+ T lymphocyte counts ≥ 500/pL,the risk of ECG abnormalities reduced (OR =0.75,95％ CI 0.58-0.96,P ＜ 0.01).Conclusions The abnormal rate of ECG in patients with HIV/AIDS is high.The sinus tachycardia and sinus rhythm with ST-T segment changes are common.The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8+ T lymphocyte counts ≥ 500/μL.Type distribution of ECG abnormalities is associated with cellular immune status of patients.
ABSTRACT
Objective@#To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients.@*Methods@#The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved. The abnormality rates and characteristics of ECG were compared between the two groups. CD4+ T lymphocyte counts, CD8+ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/AIDS patients. The comparison between two groups was conducted by chi-square test. Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients.@*Results@#There were 611 cases (54.02%) out of 1 131 HIV/AIDS patients with abnormal ECG. The common abnormal ECG types were sinus tachycardia 239 cases (39.12%), sinus rhythm with ST-T changes 115 cases (18.82%) and sinus bradycardia 55 cases (9.00%). There were 1 958 cases (34.83%) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG. The common ECG abnormality types were sinus bradycardia 633 cases (32.33%), sinus rhythm with ST-T changes 463 cases (23.65%) and sinus arrhythmia 256 cases (13.07%). The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/AIDS subjects (χ2=140.39, P<0.01). The abnormal rates of ECG in HIV/AIDS patients <50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group, and the differences were statistically significant (χ2=111.92 and 52.12, respectively, both P<0.01). Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with non-HIV/AIDS individuals (odds ratio (OR)=2.27, 95% confidence interval (CI) 2.00-2.60, P<0.01). The risk of ECG abnormality increased in patients aged ≥50 years(OR=1.60, 95%CI 1.45-1.77, P<0.01). The ECG abnormal distribution patterns were significantly different between different levels of CD4+ T lymphocyte counts, CD8+ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (χ2= 12.92, 10.99 and 16.48, respectively, all P<0.05 ). The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR=1.50, 95%CI 1.15-1.96, P<0.01). When CD8+ T lymphocyte counts ≥500/μL, the risk of ECG abnormalities reduced (OR=0.75, 95%CI 0.58-0.96, P<0.01).@*Conclusions@#The abnormal rate of ECG in patients with HIV/AIDS is high. The sinus tachycardia and sinus rhythm with ST-T segment changes are common. The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8+ T lymphocyte counts ≥500/μL. Type distribution of ECG abnormalities is associated with cellular immune status of patients.
ABSTRACT
H7N9 avian influenza is the latest subtype of influenza virus to emerge in the world. By April 17, 2013 in Shanghai, a total of 31 confirmed cases were reported, and 11 of these patients died. The epidemiological characteristics and the clinical progress of this new human flu infection are still not clear. Thirteen confirmed patients have now been treated in Shanghai Public Health Clinical Center. Among the first batch of patients, hospitalised at the beginning of April 2013, two who were admitted with the same estimated date of onset of disease had very different outcomes. After active treatment at the Centre, one recovered by April 18, 2013, but one patient entered critical condition and died on April 11, 2013. The clinical and laboratory characteristics in hospital are here analysed and compared to learn more about H7N9 avian influenza. Confirmation that the observed differences are valuable for prognosis and treatment decisions for H7N9 patients awaits authentication by analysis of more patients.