Increased risk for severe malaria in HIV-1-infected adults, Zambia.
Increased risk for severe malaria in HIV-1-infected adults, Zambia.
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DOI：
10.3201/eid1505.081009
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发表时间：
2009-05
影响因子：
11.8
通讯作者：
D'Alessandro U
中科院分区：
文献类型：
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作者：
Chalwe V;Van geertruyden JP;Mukwamataba D;Menten J;Kamalamba J;Mulenga M;D'Alessandro U
在疟疾和 HIV-1 共同流行的地区，患有严重疟疾但没有表现出免疫抑制临床症状的成年人很可能感染 HIV-1。为了确定 HIV-1 感染和 HIV-1 相关免疫抑制是否是对疟疾有一定免疫力的成年人罹患严重疟疾的危险因素，我们于 2005 年 12 月至 2007 年 3 月在赞比亚卢安夏进行了一项病例对照研究。对于每个患有严重疟疾的病例，我们选择了 2 名匹配的对照者（一名患有无并发症的疟疾的成年人和一名没有疾病迹象的成年人）。 93% 的病例患者、52% 的无并发症疟疾对照者和 45% 的无症状对照者中存在 HIV-1 感染。与无并发症的疟疾对照（比值比 [OR] 12.6，95% 置信区间 [CI] 2.0–78.8，p = 0.0005）和无症状对照（OR 16.6，95% CI 2.5–111.5，p = 0.0005）相比，HIV-1 感染是成人严重疟疾的一个非常显着的危险因素。与无症状对照者相比，严重疟疾患者的 CD4 计数更有可能<350/μL（OR 23.0，95% CI 3.35–158.00，p<0.0001）。
In areas in which malaria and HIV-1 are coendemic, adults with severe malaria who show no clinical signs of immunosuppression are likely to be infected with HIV-1. To determine whether HIV-1 infection and HIV-1–related immunosuppression were risk factors for severe malaria in adults with some immunity to malaria, we conducted a case–control study in Luanshya, Zambia, during December 2005–March 2007. For each case-patient with severe malaria, we selected 2 matched controls (an adult with uncomplicated malaria and an adult without signs of disease). HIV-1 infection was present in 93% of case-patients, in 52% of controls with uncomplicated malaria, and in 45% of asymptomatic controls. HIV-1 infection was a highly significant risk factor for adults with severe malaria compared with controls with uncomplicated malaria (odds ratio [OR] 12.6, 95% confidence interval [CI] 2.0–78.8, p = 0.0005) and asymptomatic controls (OR 16.6, 95% CI 2.5–111.5, p = 0.0005). Persons with severe malaria were more likely to have a CD4 count <350/µL than were asymptomatic controls (OR 23.0, 95% CI 3.35–158.00, p<0.0001).