Increased prevalence of severe malaria in HIV-infected adults in South Africa
Increased prevalence of severe malaria in HIV-infected adults in South Africa
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DOI：
10.1086/498023
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发表时间：
2005-12-01
影响因子：
11.8
通讯作者：
Crewe-Brown, H
中科院分区：
文献类型：
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作者：
Cohen, C;Karstaedt, A;Crewe-Brown, H
背景关于人体免疫缺陷病毒（艾滋病毒）感染对严重疟疾风险的影响，已有许多报告。我们的目的是评估艾滋病毒感染状况、免疫抑制和抗疟免疫对疟疾严重程度的影响。进行了一项前瞻性队列研究。对连续住院的成人恶性疟患者进行HIV抗体检测和CD 4（+）T细胞计数。通过获得在疟疾流行地区的儿童居住史来评估对疟疾的免疫力。对患者进行了严重疟疾的特征评估。336例患者参加了这项研究，其中32例（10%）患有严重疟疾。艾滋病毒感染率为33%，111名患者（33%）对疟疾无免疫力。艾滋病毒感染者更多地抱怨呼吸道和腹部症状，较少抱怨寒战和头痛。通过多变量分析确定的严重疟疾的危险因素包括对疟疾无免疫力、HIV血清状态阳性、寄生虫计数升高和白色血细胞计数升高。CD 4（+）T细胞计数< 200 × 10（6）cells/L的HIV感染者患严重疟疾的风险增加（P
Background. Conflicting reports exist regarding the impact of human immunodeficiency virus (HIV) infection on the risk of severe malaria. We aimed to assess the effect of HIV infection status, advancing immunosuppression, and antimalarial immunity on the severity of malaria.Methods. A prospective cohort study was conducted. Consecutive hospitalized adult patients with falciparum malaria were tested for HIV antibodies and to determine CD4(+) T cell count. Immunity to malaria was assessed by obtaining a history of childhood residence in an area where malaria is endemic. Patients were assessed for features of severe malaria.Results. Three hundred thirty-six patients were enrolled in the study, of whom 32 ( 10%) had severe malaria. The prevalence of HIV infection was 33%, and 111 patients ( 33%) were nonimmune to malaria. HIV-infected patients complained more frequently about respiratory and abdominal symptoms and less frequently about rigors and headache. Risk factors for severe malaria determined by multivariate analysis included being nonimmune to malaria, having a positive HIV serostatus, having an elevated parasite count, and having an increased white blood cell count. Risk of severe malaria was increased in HIV-infected patients with a CD4(+) T cell count of < 200 x 10(6) cells/L (P