Epidemiology of HIV-associated cryptococcosis in France (1985-2001):: comparison of the pre- and post-HAART eras
Epidemiology of HIV-associated cryptococcosis in France (1985-2001):: comparison of the pre- and post-HAART eras
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DOI：
10.1097/00002030-200402200-00024
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发表时间：
2004-02-20
期刊：
影响因子：
3.8
通讯作者：
Lortholary, O
中科院分区：
文献类型：
--
作者：
Dromer, F;Mathoulin-Pélissier, S;Lortholary, O
目的：分析引入高效抗逆转录病毒治疗（HAART）后法国隐球菌病的流行病学演变。设计：对法国国家真菌病参考中心自 1985 年以来记录的隐球菌病病例进行回顾性研究。方法：利用国家监测数据，回顾 1985 年至 2001 年间法国（人口 5900 万）诊断的 1644 例 HIV 相关隐球菌病病例并进行比较HIV 阴性患者中记录的病例数达到 335 例。结果：隐球菌病病例总数与 HIV 感染患者记录的病例总数平行变化。分析了HAART引入后发生的变化。负二项回归模型显示，与HAART之前时代（1985-1996，n = 1352）相比，HAART之后时代（1997-2001，n = 292）隐球菌病的发病率下降了46%。根据多变量分析，非洲血统、年龄较大、异性恋 HIV 感染、既往没有艾滋病定义疾病以及既往没有 HIV 感染诊断是与后 HAART 时代隐球菌病风险增加独立相关的变量。同一时期，HIV 阴性人群的特征没有改变。结论：我们对国家监测的分析确定了与后 HAART 时代隐球菌病风险增加相关的人口因素，表明未能咨询和认为自己没有风险是法国目前 HIV 相关隐球菌病流行病学的决定因素。 (C) 2004 年利平科特·威廉姆斯·威尔金斯。
Objective: To analyse the epidemiological evolution of cryptococcosis in France after the introduction of highly active antiretroviral therapy (HAART).Design: Retrospective study of cryptococcosis cases recorded at the National Reference Center for Mycoses in France since 1985.Methods: Using the national surveillance data, we reviewed 1644 cases of HIV-associated cryptococcosis diagnosed in France (population, 59 million) between 1985 and 2001 and compared them to 335 cases recorded in HIV-negative patients.Results: The total number of cryptococcosis cases evolved in parallel to that recorded for HIV-infected patients. Changes occurring after HAART introduction were analysed. A negative binomial regression model established a 46% decrease of the incidence of cryptococcosis during the post-HAART era (1997-2001, n = 292) compared to the pre-HAART era (1985-1996, n = 1352). According to multivariate analysis, African origin, older age, heterosexual HIV contamination, no previous AIDS-defining illness, and no previous HIV infection diagnosis were variables independently associated with an increased risk of cryptococcosis during the post-HAART era. During the same period, the characteristics of the HIV-negative population did not change.Conclusions: Our analysis of the national surveillance identified demographic factors associated with an increased risk of cryptococcosis in the post-HAART era suggesting that failure to consult and considering oneself not at risk were determinant in the current epidemiology of HIV-related cryptococcosis in France. (C) 2004 Lippincott Williams Wilkins.