Cause of death and presence of respiratory disease at autopsy in an HIV-1 seroconversion cohort of southern African gold miners
Cause of death and presence of respiratory disease at autopsy in an HIV-1 seroconversion cohort of southern African gold miners
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DOI：
10.1097/01.aids.0000299416.61808.24
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发表时间：
2007-11-01
期刊：
影响因子：
3.8
通讯作者：
Glynn, Judith R.
中科院分区：
文献类型：
--
作者：
Murray, Jill;Sonnenberg, Pam;Glynn, Judith R.
目的：描述在抗逆转录病毒治疗前的时期，HIV感染矿工的死亡和呼吸道感染的原因，按照HIV感染的持续时间。设计：从20世纪90年代早期到2002年，对1950名已知HIV血清转化日期的金矿工人和6164名HIV阴性矿工进行了回顾性队列研究。人事记录、临床记录、死亡证明和为赔偿目的进行的心肺器官尸检。结果：308名艾滋病毒阳性患者中有279名（91%）和254名艾滋病毒阴性患者中有234名（92%）的死亡原因已知在受雇期间或离职后6个月内死亡的男子。非自然原因造成的死亡率在艾滋病毒阳性和艾滋病毒阴性矿工中相似，并按艾滋病毒感染的持续时间分列。在自然死亡中，87%的艾滋病毒阳性和41%的艾滋病毒阴性个体是由感染引起的（P < 0.001）; 47%的艾滋病毒阳性和26%的艾滋病毒阴性个体患有结核病。自然原因导致的任何感染或特定感染（肺结核、隐球菌、肺囊虫）死亡的比例不随艾滋病毒感染的持续时间而变化。29%的自然死亡男性进行尸检：83%的HIV阳性和37%的HIV阴性男性有呼吸道感染（P < 0.001），其中一半是临床未确诊的。结论：结核病是HIV阳性和阴性男性自然死亡的主要死因。虽然自然原因导致的死亡率随着艾滋病毒感染的持续时间大大增加，但疾病模式几乎没有改变，这表明缓慢和快速进展者死于相同范围的疾病。(C)2007年威科健康垂直酒吧利平科特威廉姆斯&威尔金斯。
Objectives: To describe causes of death and respiratory infections in HIV-infected miners in the pre-antiretroviral era, by duration of HIV infection.Design: A retrospective cohort of 1950 gold miners with known dates of HIV seroconversion and 6164 HIV-negative miners was followed from the early 1990s to 2002.Methods: Causes of death were available from multiple sources: personnel records, clinical records, death certificates and autopsies of cardiorespiratory organs performed for compensation purposes.Results: Causes of death were known for 279 of 308 HIV-positive (91%)and 234 of 254 HIV-negative (92%) men who died while employed or within 6 months of leaving employment. The mortality rate from unnatural causes was similar in HIV-positive and HIV-negative miners and by duration of HIV infection. Among deaths from natural causes, 87% in HIV-positive and 41% in HIV-negative individuals were caused by infection (P < 0.001); 47% of HIV-positive and 26% of HIV-negative individuals had tuberculosis. The proportion of deaths from natural causes with any infection, or with specific infections (tuberculosis, cryptococcus, pneumocystis), did not vary with the duration of HIV infection. Autopsies were performed on 29% of men who died from natural causes: 83% of HIV-positive and 37% of HIV-negative men had respiratory infections (P < 0.001), half of which were clinically undiagnosed.Conclusion: Tuberculosis was the leading cause of death in HIV-positive and negative men who died from natural causes. Although the mortality rate from natural causes increased greatly with the duration of HIV infection, the pattern of disease hardly changed, suggesting that slow and fast progressors succumb to the same range of diseases. (C) 2007 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.