Acta Dermatovenerologica Alpina Pannonica et Adriatica最新文献_第9页

Trigeminal trophic syndrome, a rare and often overlooked cause of facial ulceration: a case report and literature review. 三叉神经营养综合征，一个罕见的和经常被忽视的原因面部溃疡:一个病例报告和文献复习。

IF 1.2 Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-03-01

Laura Đorđević Betetto, Vid Bajuk

Trigeminal trophic syndrome (TTS) is an uncommon and relatively unknown cause of facial ulceration that occurs after damage to the trigeminal nerve. It characteristically involves non-healing facial ulceration(s) with accompanying anesthesia, paresthesia, and dysesthesia along the distribution of a trigeminal dermatome. The ulcerations are believed to be self-induced in response to paresthesia. The disease is most common in middle-aged women, manifesting as a unilateral crescent-shaped ulceration on the ala nasi, with sparing of the nasal tip. The diagnosis is clinical and mostly based on exclusion of other possible causes of facial ulcerations, with emphasis on neoplasms, infection-associated vasculitis, and factitial disorders. There are no specific histological or laboratory signs. There is no standard treatment protocol; however, a number of different successful strategies have been reported, including pharmaceutical and surgical interventions, transcutaneous nerve stimulation, and simple occlusion dressings. Due to the self-inflicted nature of this disorder, the cornerstone of management is patient education with behavioral modification. Here, we report a case of TTS following herpes zoster ophthalmicus and review the current literature on this subject.

三叉神经营养综合征(TTS)是一种罕见且相对未知的原因，发生在三叉神经损伤后的面部溃疡。它的特征包括伴有麻醉、感觉异常和沿三叉皮节分布的感觉不良的面部溃疡。溃疡被认为是对感觉异常的自我诱导。此病最常见于中年妇女，表现为鼻翼单侧月牙形溃疡，鼻尖不受影响。诊断是临床的，主要是基于排除其他可能的面部溃疡原因，重点是肿瘤、感染相关血管炎和人为疾病。没有特定的组织学或实验室征象。没有标准的治疗方案;然而，已经报道了许多不同的成功策略，包括药物和手术干预，经皮神经刺激和简单的闭塞敷料。由于这种疾病的自我造成的性质，管理的基石是患者教育与行为改变。在此，我们报告一例眼带状疱疹后的TTS，并回顾目前关于这一主题的文献。

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引用次数: 0

Primary biliary cholangitis-cause or association with psoriasis: a case report. 原发性胆道胆管炎与牛皮癣相关:1例报告。

IF 1.2 Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-03-01

Patricija Tomše, Valerija Balkovec

Primary biliary cholangitis is a chronic progressive cholestatic granulomatous and destructive inflammatory lesion of small intralobular and septal bile ducts that primarily affects women. The exact etiology of this disease has not yet been elucidated; however, it is believed to be the result of a combination of environmental triggers in genetically predisposed individuals. It can manifest itself simultaneously with, before, or after the onset of psoriasis and other skin autoimmune diseases. Standard treatment is ursodeoxycholic acid. A 65-year-old patient presenting with elevated hepatic laboratory findings that had persisted for several years and normal abdominal ultrasound was additionally diagnosed with primary biliary cholangitis after 2 years on a biological drug for psoriasis. She did not have other symptoms except elevated liver tests. The skin showed a strong response to biological therapy and treatment with ursodeoxycholic acid prompted lowering of liver enzymes. The skin was clear all throughout the treatment. This article emphasizes the importance of additional diagnostic workups in patients with psoriasis and elevated hepatic laboratory findings.

原发性胆管炎是一种慢性进行性胆汁淤积性肉芽肿和破坏性的小叶内和间隔胆管炎症性病变，主要影响女性。这种疾病的确切病因尚未阐明;然而，它被认为是遗传易感性个体的环境触发因素组合的结果。它可以与牛皮癣和其他皮肤自身免疫性疾病同时出现，在发病之前或之后。标准治疗是熊去氧胆酸。一名65岁的患者，肝脏实验室检查结果升高，持续数年，腹部超声正常，在服用牛皮癣生物药物2年后，又被诊断为原发性胆管炎。除了肝脏检查结果升高外，她没有其他症状。皮肤对生物疗法和熊去氧胆酸治疗表现出强烈的反应，导致肝酶降低。在整个治疗过程中，皮肤都很干净。这篇文章强调了银屑病患者和肝脏实验室检查结果升高的额外诊断检查的重要性。

引用次数: 0

Trigeminal trophic syndrome, a rare and often overlooked cause of facial ulceration: a case report and literature review. 三叉神经营养综合征，一个罕见的和经常被忽视的原因面部溃疡:一个病例报告和文献复习。

IF 1.2 Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-03-01 DOI: 10.15570/actaapa.2023.7

Laura Đorđević Betetto, Vid Bajuk

Trigeminal trophic syndrome (TTS) is an uncommon and relatively unknown cause of facial ulceration that occurs after damage to the trigeminal nerve. It characteristically involves non-healing facial ulceration(s) with accompanying anesthesia, paresthesia, and dysesthesia along the distribution of a trigeminal dermatome. The ulcerations are believed to be self-induced in response to paresthesia. The disease is most common in middle-aged women, manifesting as a unilateral crescent-shaped ulceration on the ala nasi, with sparing of the nasal tip. The diagnosis is clinical and mostly based on exclusion of other possible causes of facial ulcerations, with emphasis on neoplasms, infection-associated vasculitis, and factitial disorders. There are no specific histological or laboratory signs. There is no standard treatment protocol; however, a number of different successful strategies have been reported, including pharmaceutical and surgical interventions, transcutaneous nerve stimulation, and simple occlusion dressings. Due to the self-inflicted nature of this disorder, the cornerstone of management is patient education with behavioral modification. Here, we report a case of TTS following herpes zoster ophthalmicus and review the current literature on this subject.

三叉神经营养综合征(TTS)是一种罕见且相对未知的原因，发生在三叉神经损伤后的面部溃疡。它的特征包括伴有麻醉、感觉异常和沿三叉皮节分布的感觉不良的面部溃疡。溃疡被认为是对感觉异常的自我诱导。此病最常见于中年妇女，表现为鼻翼单侧月牙形溃疡，鼻尖不受影响。诊断是临床的，主要是基于排除其他可能的面部溃疡原因，重点是肿瘤、感染相关血管炎和人为疾病。没有特定的组织学或实验室征象。没有标准的治疗方案;然而，已经报道了许多不同的成功策略，包括药物和手术干预，经皮神经刺激和简单的闭塞敷料。由于这种疾病的自我造成的性质，管理的基石是患者教育与行为改变。在此，我们报告一例眼带状疱疹后的TTS，并回顾目前关于这一主题的文献。

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引用次数: 1

Linear IgA bullous dermatosis in an acute myeloid leukemia patient: a rare case report. 急性髓系白血病患者线状IgA大疱性皮肤病:罕见病例报告。

IF 1.2 Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-03-01 DOI: 10.15570/actaapa.2023.5

Deisy Vania Kianindra, A. Rosa, Dina Pebriany, W. Dewiyanti, A. Madjid

Linear IgA bullous dermatosis (LABD) is a rare autoimmune bullous disease characterized by linear IgA deposition along the skin basal membrane. In children, LABD classically presents with a "cluster of jewels" appearance, whereas in adults the classic presentation is itchy papules with tense vesicles and bullae on an erythematous base. We report the case of a 41-year-old woman with LABD that we suspect was induced by acute myeloid leukemia presenting with multiple vesicles and bullae that coalesced, forming the typical clinical manifestation of LABD and confirmed with histopathological and direct immunofluorescence. The patient was treated with a combination of oral and topical corticosteroids with excellent results.

线性IgA大疱性皮肤病(LABD)是一种罕见的自身免疫性大疱性疾病，其特征是IgA沿皮肤基膜呈线性沉积。在儿童中，LABD典型表现为“宝石簇”外观，而在成人中，典型表现为瘙痒丘疹，红斑基础上有紧张的囊泡和大泡。我们报告一例41岁女性LABD，我们怀疑是由急性髓性白血病引起的，表现为多个囊泡和大泡合并，形成LABD的典型临床表现，并经组织病理学和直接免疫荧光证实。患者接受口服和外用皮质类固醇联合治疗，效果良好。

引用次数: 0

Pembrolizumab-induced lichen planus in patients with metastatic melanoma: a report of two cases and prognostic implications of cutaneous immune-related adverse events pembrolizumab诱导的转移性黑色素瘤患者扁平苔藓:两例皮肤免疫相关不良事件的报告及其预后意义

Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-01-01 DOI: 10.15570/actaapa.2023.22

Tanja Tirnanić, Danica Tiodorović, Nataša Vidović, Mirjana Balić, Nenad Petrov, Lidija Kandolf, Željko Mijušković

Patients receiving immune checkpoint inhibitors (ICIs) commonly experience cutaneous immune-related adverse events (irAEs). We present two cases, a 51-year-old female and a 70-year-old male, that were undergoing treatment with pembrolizumab for metastatic melanoma and developed scaly, erythematous papules on their skin. Following skin biopsies, histological analysis confirmed the diagnosis of lichen planus. In the first patient, acitretin at a dosage of 25 mg/day was administered for 6 months, resulting in complete resolution of lichen lesions. Imaging scans showed no signs of melanoma. The second patient was treated with topical betamethasone dipropionate ointment for several weeks, which led to a favorable therapeutic response. During follow-up, a thoracic CT scan showed several micronodular lesions in the right lung, whereas brain and abdomen CT scans showed no signs of the disease. Lichen planus is not a commonly reported irAE in patients treated with ICIs. This report underscores the importance of conducting skin biopsies in patients receiving ICI therapy and highlights the potential prognostic importance of skin irAEs in patients with melanoma receiving such treatment.

接受免疫检查点抑制剂(ICIs)的患者通常会经历皮肤免疫相关不良事件(irAEs)。我们报告了两例病例，一名51岁的女性和一名70岁的男性，他们接受了派姆单抗治疗转移性黑色素瘤，并在皮肤上出现了鳞片状的红斑丘疹。皮肤活检后，组织学分析证实了扁平苔藓的诊断。在第一个患者中，阿维甲素的剂量为25mg /天，持续6个月，导致地衣病变完全消退。成像扫描显示没有黑色素瘤的迹象。第二例患者局部应用二丙酸倍他米松软膏治疗数周，治疗效果良好。在随访期间，胸部CT扫描显示右肺有几个小结节病变，而脑部和腹部CT扫描未显示该疾病的迹象。扁平苔藓在接受ICIs治疗的患者中并不是常见的irAE。本报告强调了在接受ICI治疗的患者中进行皮肤活检的重要性，并强调了在接受这种治疗的黑色素瘤患者中皮肤irae的潜在预后重要性。

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引用次数: 1

Prevalence of the HLA-Cw6 genotype and zinc deficiency in psoriasis vulgaris patients in Indonesia 印度尼西亚寻常型银屑病患者HLA-Cw6基因型和锌缺乏症的患病率

Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-01-01 DOI: 10.15570/actaapa.2023.19

Timothy Yusuf Sangian, Nurelly Noro Waspodo, Faridha Ilyas, Khairuddin Djawad, Arifin Seweng, Suryani Tawali

INTRODUCTION Psoriasis vulgaris is an immune-mediated inflammatory disease influenced by genetic and immunologic factors, including micronutrient deficiencies. The HLA-Cw6 gene and zinc level have been separately studied in psoriasis patients, yielding inconsistent findings. A descriptive study regarding HLA-Cw6 allele expression, zinc levels, and their direct correlation in Indonesia is lacking. METHODS This prospective case-control study involved 33 psoriasis patients and 33 age- and sex-matched control patients at the dermatology clinic affiliated with Hasanuddin University in South Sulawesi in 2021. Cases were classified into mild, moderate, and severe psoriasis according to Psoriasis Area and Severity Index (PASI) score. An EDTA tube was used to take a 5 ml blood sample, followed by analysis for PCR of the HLA-Cw6 allele and a colorimetric assay to measure zinc level. Statistical analysis was performed to determine the association between HLA-Cw6 and zinc level and psoriasis disease severity. RESULTS Among the 33 psoriatic patients enrolled in this study, three (9.1%) of the cases were classified as mild psoriasis, 10 (30.3%) were classified as moderate psoriasis, and 20 (60.6%) were classified as severe psoriasis. The HLA-Cw6 allele was detected in 93.9% of psoriasis cases and in 3% of control patients (p < 0.001). The HLA-Cw6 allele was detected consecutively in 66.7%, 90.0%, and 100% of mild, moderate, and severe psoriasis patients, respectively. Zinc levels were lower in psoriasis patients compared to controls (16.85 ± 3.55 vs. 13.74 ± 3.78 μmol/l). Severe psoriasis patients exhibited the lowest average zinc level (14.76 ± 1.40 μmol/l, 15.48 ± 4.20 μmol/l, and 12.72 ± 3.56 μmol/l in mild, moderate, and severe patients, respectively). The mean zinc level in HLA-Cw6-positive patients was 13.68 μmol/l, and 14.6 μmol/l in HLA-Cw6-negative patients (p = 0.495). CONCLUSIONS The study revealed the presence of HLA-Cw6 allele expression and decreased serum zinc levels in psoriasis patients compared to controls. Both factors demonstrated associations with psoriasis disease severity.

寻常型银屑病是一种受遗传和免疫因素影响的免疫介导的炎症性疾病，包括微量营养素缺乏。银屑病患者的HLA-Cw6基因和锌水平分别研究，结果不一致。在印度尼西亚缺乏关于HLA-Cw6等位基因表达、锌水平及其直接相关性的描述性研究。这项前瞻性病例对照研究于2021年在南苏拉威西Hasanuddin大学附属皮肤科诊所纳入了33名牛皮癣患者和33名年龄和性别匹配的对照患者。根据银屑病面积及严重程度指数(psoriasis Area and Severity Index, PASI)评分将患者分为轻度、中度和重度。用EDTA管取5 ml血样，随后进行HLA-Cw6等位基因PCR分析和比色法测定锌水平。统计分析HLA-Cw6和锌水平与银屑病严重程度之间的关系。本研究纳入的33例银屑病患者中，轻度银屑病3例(9.1%)，中度银屑病10例(30.3%)，重度银屑病20例(60.6%)。HLA-Cw6等位基因在93.9%的银屑病患者和3%的对照患者中检测到(p < 0.001)。HLA-Cw6等位基因在轻、中、重度牛皮癣患者中分别连续检测到66.7%、90.0%和100%。银屑病患者的锌水平低于对照组(16.85±3.55 μmol/l vs. 13.74±3.78 μmol/l)。重度银屑病患者的平均锌含量最低(轻、中、重度患者分别为14.76±1.40 μmol/l、15.48±4.20 μmol/l、12.72±3.56 μmol/l)。hla - cw6阳性患者的平均锌水平为13.68 μmol/l，阴性患者的平均锌水平为14.6 μmol/l (p = 0.495)。该研究显示，与对照组相比，银屑病患者存在HLA-Cw6等位基因表达和血清锌水平下降。这两个因素都与银屑病的严重程度有关。

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引用次数: 0

Safety and efficacy of intralesional injection of enalapril versus triamcinolone acetonide in the treatment of keloids 病灶内注射依那普利与曲安奈德治疗瘢痕疙瘩的安全性和有效性比较

Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-01-01 DOI: 10.15570/actaapa.2023.16

Basma Hamada Mohamed, Samar Eltahlawy, Walaa Ahmed Marzouk, Noha E. Mohamad

Keloids are pathologic conditions characterized by fibroblast hyper-proliferation and excess collagen deposition. Enalapril, one of the angiotensin-converting enzyme inhibitors, has recently been highlighted as a new therapeutic modality in treating keloids. This study evaluates the effectiveness of intralesional injection of enalapril versus triamcinolone acetonide (TAA) in keloids.Forty patients with multiple keloids were enrolled in our study. Enalapril and TAA were injected intralesionally in one session per month for three sessions. The clinical outcomes were assessed via the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS).In both groups, according to VSS and POSAS, there was a high statistically significant difference (p-value ≤ 0.01) before treatment, at the end of each session, and 3 months after treatment. There was no significant difference between both groups regarding degree of improvement. Patients treated with TAA developed more significant complications than those in the enalapril group (p-value < 0.05).Both enalapril and TAA had the same clinical effect. Enalapril could be a safe alternative to steroids in the treatment of keloid and hypertrophic scars. Further studies on enalapril are needed on a large sample of patients with further focus on the mechanism of this innovative drug.

瘢痕疙瘩是一种以成纤维细胞过度增生和过多胶原沉积为特征的病理状态。依那普利是血管紧张素转换酶抑制剂之一，近年来作为治疗瘢痕疙瘩的一种新的治疗方式而受到重视。本研究评价瘢痕疙瘩病灶内注射依那普利与曲安奈德(TAA)的疗效。40例多发性瘢痕疙瘩患者参加了我们的研究。依那普利和TAA静脉注射，每月一次，共3次。临床结果通过温哥华疤痕量表(VSS)和患者和观察者疤痕评估量表(POSAS)进行评估。根据VSS和POSAS，两组在治疗前、每次治疗结束时和治疗后3个月的差异均有很高的统计学意义(p值≤0.01)。两组在改善程度上无显著差异。TAA组患者并发症发生率高于依那普利组(p值< 0.05)。依那普利与TAA的临床疗效相同。依那普利可能是一种安全的替代类固醇治疗瘢痕疙瘩和增生性疤痕。对依那普利的进一步研究需要在大样本患者中进行，进一步关注这种创新药物的机制。

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引用次数: 0

Swelling of inguinal lymph nodes in a patient with HIV: a case report HIV患者腹股沟淋巴结肿大1例报告

Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-01-01 DOI: 10.15570/actaapa.2023.23

Mark Sergej Bartenjev, Maja Mastnak, Darja Keše, Andreja Murnik Rauh

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by the L1, L2, and L3 serotypes of Chlamydia trachomatis (CT). It primarily affects regional lymph nodes. Although it is not endemic in Europe and North America, recent reports indicate an increasing prevalence among men who have sex with men, with proctocolitis as the most frequently reported symptom. We report the case of a homosexual male that presented to our department with a nodular lesion on the shaft of the penis and tender, enlarged inguinal lymph nodes. Throat, urethral, and rectal swabs were collected for CT testing using real-time polymerase chain reaction. The urethral swab was positive for CT, whereas the throat and rectal swabs were negative. Subsequent testing detected the presence of LGV DNA. The patient was treated with a prolonged course of doxycycline. After 6 weeks, the urethral swab for CT returned a negative result. The patient reported complete remission 7 weeks after the start of treatment.

性病性淋巴肉芽肿(LGV)是一种由沙眼衣原体(CT) L1、L2和L3血清型引起的性传播感染。它主要影响局部淋巴结。虽然它在欧洲和北美并不流行，但最近的报告表明，在男男性行为的男性中患病率越来越高，直结肠炎是最常见的报告症状。我们报告的情况下，一名同性恋男子，提出了一个结节性病变的阴茎轴和柔软，扩大腹股沟淋巴结。收集喉部、尿道和直肠拭子，采用实时聚合酶链反应进行CT检测。尿道拭子CT阳性，喉部和直肠拭子CT阴性。随后的测试检测到LGV DNA的存在。患者接受了延长疗程的强力霉素治疗。6周后，尿道拭子CT结果为阴性。患者在开始治疗7周后报告完全缓解。

引用次数: 0

Colocalizing paraneoplastic alopecia areata and nodular basal cell carcinoma 副肿瘤性斑秃和结节性基底细胞癌的共定位

Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-01-01 DOI: 10.15570/actaapa.2023.24

Martina Lambertini, Costantino Ricci, Bor Hrvatin Stancic, Martina Mussi, Barbara Corti, Cosimo Misciali, Bianca Maria Piraccini, Emi Dika

1IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 2Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy. 3Pathology Unit, Maggiore Hospital-AUSL Bologna, Bologna, Italy. 4Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy. 5Dermatovenerology Department, Ljubljana University Medical Center, Ljubljana, Slovenia. 6Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. 7Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy.

引用次数: 0

HIV-1 subtype diversity and phylogenetic insight into non-B subtype transmission in Slovenia, 1989-2013 1989-2013年斯洛文尼亚HIV-1亚型多样性和非b亚型传播的系统发育观察

Q4 DERMATOLOGY

Acta Dermatovenerologica Alpina Pannonica et Adriatica

Pub Date : 2023-01-01 DOI: 10.15570/actaapa.2023.20

Jana Mlakar, Maja M. Lunar, Ana B. Abecasis, Anne-Mieke Vandamme, Janez Tomažič, Tomaž D. Vovko, Blaž Pečavar, Gabriele Turel, Mario Poljak

Disease progression, drug resistance mutations, and treatment strategies may vary by HIV-1 subtype. This study determined HIV-1 subtypes circulating in Slovenia, a Central European country with an HIV-1 epidemic driven by men who have sex with men, focusing on molecular epidemiology of non-B subtypes.A total of 367 HIV-1 sequences were included. Subtype was assigned by employing eight different HIV subtyping tools coupled with maximum likelihood phylogenetic analyses.The subtyping tools COMET, jpHMM, and REGA 3.0 exhibited the best performance on the dataset studied. Phylogenetic analyses showed a 14.7% prevalence of non-B subtypes, with subtype A detected most frequently (4.9%), followed by CRF02_AG (2.4%), subtype C (1.1%), subtypes D, G, and CRF01_AE (0.8% each), and subtypes F and CRF22_01A1 (0.3% each). A subtype could not be assigned to 12 sequences (3.3%), indicating potential unique recombinant forms. Non-B subtypes were significantly associated with a heterosexual route of transmission and infection acquired in Eastern Europe, Africa, or Asia.In a country where subtype B is predominant, non-B subtypes were observed in one out of seven patients, a non-negligible proportion, which underlines the importance of systematic surveillance of HIV subtype diversity and the corresponding molecular epidemiology.

疾病进展、耐药突变和治疗策略可能因HIV-1亚型而异。本研究确定了在中欧国家斯洛文尼亚流行的HIV-1亚型，该国家HIV-1流行由男男性行为者驱动，重点关注非b亚型的分子流行病学。共包含367个HIV-1序列。通过采用8种不同的HIV亚型分型工具以及最大似然系统发育分析来确定亚型。在所研究的数据集上，亚型工具COMET、jpHMM和REGA 3.0表现出最好的性能。系统发育分析显示，非b亚型的患病率为14.7%，其中a亚型最多(4.9%)，其次是CRF02_AG (2.4%)， C亚型(1.1%)，D、G和CRF01_AE亚型(各0.8%)，F和CRF22_01A1亚型(各0.3%)。有12个序列(3.3%)不能找到一个亚型，表明可能存在独特的重组形式。在东欧、非洲或亚洲，非b亚型与异性恋传播途径和感染显著相关。在一个以B亚型为主的国家，非B亚型在七分之一的患者中观察到，这是一个不可忽视的比例，这强调了系统监测艾滋病毒亚型多样性和相应的分子流行病学的重要性。

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引用次数: 0