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NEJM:艾滋病患者HPV相关的口腔乳头瘤样增生-病例报道

2016-06-30 MedSci MedSci原创

患者男性,36岁,患有获得性免疫缺陷综合征(AIDS)和卡波西肉瘤,2年前口腔内开始出现广泛的无痛性乳头瘤样病变(如下图所示)。患者的性取向为男性,其男朋友存在生殖器疣病史。采用高活性抗逆转录病毒疗法治疗患者。血液中人类免疫缺陷病毒(HIV)1型的水平低于20拷贝/ml,和CD4 + T细胞计数为318个/ml。体格检查显示,患者存在广泛的唇、腭和口腔口腔疣状结节病变与尖锐湿疣表现一致。组织病理学

患者男性,36岁,患有获得性免疫缺陷综合征(AIDS)和卡波西肉瘤,2年前口腔内开始出现广泛的无痛性乳头瘤样病变(如下图所示)。




患者的性取向为男性,其男朋友存在生殖器疣病史。

采用高活性抗逆转录病毒疗法治疗患者。

血液中人类免疫缺陷病毒(HIV)1型的水平低于20拷贝/ml,和CD4 + T细胞计数为318个/ml。体格检查显示,患者存在广泛的唇、腭和口腔口腔疣状结节病变与尖锐湿疣表现一致。组织病理学和免疫组化研究证实为人类乳头状瘤病毒(HPV)6型和11型感染。

在随后的2年中,患者接受多个疗程的二氧化碳激光治疗以消除口腔病变。

与未合并HIV感染的患者相比,合并感染HIV的患者其HPV相关的疣状病变可更持久,更广泛,侵袭性更强。免疫监视(CD4 + T细胞计数低于200个/ml)受损不仅会减少HPV常规治疗的有效性,还会提高尖锐湿疣复发的风险。

原始出处:

Jacobo Limeres Posse, Crispian Scully, Oral HPV-Associated Papillomatosis in AIDS. N Engl J Med 2016; 374:2585June 30, 2016DOI: 10.1056/NEJMicm1512047.

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    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

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  3. [GetPortalCommentsPageByObjectIdResponse(id=144932, encodeId=e6f8144932a0, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 18:39:49 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1958054, encodeId=5a411958054be, content=<a href='/topic/show?id=a2cd868009b' target=_blank style='color:#2F92EE;'>#艾滋病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86800, encryptionId=a2cd868009b, topicName=艾滋病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c83329, createdName=10518093zz, createdTime=Sun May 14 06:57:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=123868, encodeId=e9451238681d, content=赞了!深度好文,学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Sep 12 19:09:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=123401, encodeId=d44b1234017e, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Mon Sep 12 10:50:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91681, encodeId=925091681c3, content=好恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Fri Jul 01 08:28:00 CST 2016, time=2016-07-01, status=1, ipAttribution=)]
    2016-09-12 ylzr123

    赞了!深度好文,学习。

    0

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    2016-09-12 1e10c84am36(暂无匿称)

    文章不错

    0

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    2016-07-01 oo902

    好恐怖啊

    0

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随着膜介导的融合,HIV-1病毒核释放到靶细胞的细胞质中,经过一系列的转运和复制可使得病毒基因组进入靶细胞核,最终导致前病毒DNA整合到宿主细胞的基因组中。既往研究已经发现,破坏微管或耗竭动力蛋白/驱动蛋白的马达,可干扰病毒基因组的正常脱壳和转运。该研究发现,HIV-1感染过程中,驱动蛋白-1的马达(KIF5B)可诱导核孔成分Nup358的重新定位。Nup358的重新定位依赖于HIV-1衣壳,且N

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